Discussion Of Topics Research Articles

Training of postgraduate year 2 critical care pharmacists in care of the obstetric patient.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. The purpose of this study was to characterize the current state of training in the care of critically ill obstetric patients for postgraduate year 2 (PGY2) critical care pharmacy residents across the US. Additionally, we sought to compare the level of comfort in caring for these patients between those who received training during their residency and those who did not. This was a descriptive analysis of the training provided to PGY2 critical care pharmacy residents. Two surveys were sent to residency program directors (RPDs) and to current residents and recent graduates of PGY2 critical care pharmacy training programs. A total of 44 RPDs responded to the survey. Of the respondents, 9% indicated that their program has an obstetrics rotation while 66% of programs include case reviews or topic discussions. Forty-two current residents and recent graduates of PGY2 critical care pharmacy training programs responded to the survey. Of those who responded, 24% indicated that they had a formal rotation experience. The median comfort level in care of critically ill obstetric patients was significantly higher for pharmacists who had received training vs those who had not (P < 0.001). These survey results highlight an opportunity for more thorough training in care of critically ill obstetric patients for PGY2 critical care pharmacy residents. This training is associated with increased comfort level in caring for these complex patients.

Discussion of HIV and Other Sexually Transmitted Infections With Sex Partners of Nigerian Men Who Have Sex With Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices.

Discussion of HIV and other sexually transmitted infections among sex partners facilitates risk reduction. We evaluated HIV/STI-related communications, including broad assessment of any self-reported discussion of the topic and specific discussion of each partner's HIV status, among a historically marginalized and presently criminalized community of sexual and gender minorities (SGM) in Nigeria. From 2013 to 2018, we enrolled SGM aged 18+ years in Lagos or 16+ years in Abuja who reported anal sex with men. At enrollment and 3-, 9-, and 15-month follow-up visits, participants were asked about their sexual behaviors and communications with main sexual partners (MSP) and casual sexual partners (CSP). Questions included "have you talked with your [MSP/CSP] about sexually transmitted infections and HIV?" Multivariable robust Poisson regression with generalized estimating equations was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV/STI-related communications with some or all of each type of sexual partner. Among 2795 SGM enrolled with median age 23 years (interquartile range 20-27), questions about HIV/STI-related communications with MSP were answered by 2436 (87.2%) and with CSP by 2398 (85.9%) SGM. Communication with MSP was reported by 68.1% (1659/2436), of whom 897 (54.1%) discussed their own HIV status and 925 (55.8%) discussed their partner's status. Communication with CSP was reported by 43.9% (1052/2398), of whom 389 (37.0%) discussed their own HIV status and 385 (36.6%) discussed their partner's status. Among participants with both MSP and CSP, HIV/STI-related communication with MSP was more common among participants with higher than secondary education [aRR 1.40 (95% CI: 1.24 to 1.58)], who were divorced/separated/widowed [aRR 1.19 (95% CI: 1.06 to 1.33)], who discussed their HIV status with CSP [aRR 1.18 (95% CI: 1.10 to 1.25)], discussed CSP's HIV status [aRR 1.20 (95% CI: 1.13 to 1.27)], and used a condom at last sex with CSP [aRR 1.16 (95% CI: 1.08 to 1.25)]. HIV/STI-related communication with CSP was more common among participants with higher than secondary education [aRR 1.36 (95% CI: 1.12 to 1.66)], who were divorced/separated/widowed [aRR 1.38 (95% CI: 1.13 to 1.69)], who discussed their HIV status with MSP [aRR 1.47 (95% CI: 1.27 to 1.69)], who discussed CSP's HIV status [aRR 1.22 (95% CI: 1.06 to 1.40)], and used a condom at last sex with CSP [aRR 1.22 (95% CI: 1.08 to 1.38)]. HIV/STI-related communications with main and casual sex partners were both associated with safer sex with CSP. HIV prevention and treatment programs for SGM should promote open communications in sexual relationships and consider deployment of modern strategies to facilitate disclosure, especially in settings with criminalizing legislation.

A Discussion of Topics Related to Teaching a Graduate Stuttering Course

A Discussion of Topics Related to Teaching a Graduate Stuttering Course

On the formation of a new world order

The thesis of the formation of a new world order is widespread in both Russian and foreign political discourse, but it needs to be substantiated. The rejection of the ‘old' world order also requires clarification: what exactly is unacceptable and what should be radically restructured. Since the end of the WWI, the original time marker of the existing world order, the question of its renewal has come up five or six times. Today, as always, it is important to assess the changes in the balance of power on the world stage. They affect (i) the main actors, their roles, activities, algorithms of behaviour; (ii) the tools at their disposal that can be used to interact with the international environment; (iii) new coalition rapprochements and new cleavages in the international arena; (iv) new global and regional balances (regarding military, economic, resource, scientific, technical and other potentials). The question is whether this results in the accumulation of a new quality by the international system, which requires its radical renewal, or whether the system is able to absorb changing realities, adapting to them and improving the existing algorithms of its own functioning. The time factor can work not only to accelerate new trends, but also to promote the inertia of the existing ones. In some areas (globalization, the role of multilateral institutions, arms control) the resources possessed by the existing international system by no means seem to be exhausted. Finally, the abstractly formulated idea of the need for a new world order does not clarify some problems of an existential nature: (i) the hierarchy of the international system and the consequences of its ‘softening,' (ii) the unequal availability of various elements of stability/power (technology, information, resources, financial instruments, human capital, movement of people, social stability, etc.) for different states and societies, (iii) the correlation of internal problems and relations with the outside world, (iv) the phenomenon of sovereign particularism. As topics for further discussion, briefly formulated criteria for sustainability, effectiveness, maturity and adaptive capabilities of the world order are proposed.

P-584. Tailored telehealth behavioral health coaching demonstrates feasibility and potential in overcoming barriers to HIV treatment outcomes

Abstract Background People with HIV (PWH) face challenges, including behavioral health, stigma, financial constraints, homelessness and homophobia that negatively impact their HIV care. Unfortunately, limited, tailored programs exist to address these problems. Additionally, transportation and time constraints may hinder participation in available programs. Thus, Nebraska’s Specialty Care Center implemented the Intervention to Telehealth and Text to Improve Engagement in Care (i2TEC), a Health Resources and Services Administration (HRSA) HIV/AIDS Bureau-funded evidence-informed intervention aimed to address the intersection of mental health, substance use, and HIV. Here, we describe i2TEC program and its early impact on viral suppression (VS) among PWH in Nebraska. Methods Delivered by a licensed behavioral health therapist (BHT), participants receive 12 weekly behavioral health virtual coaching sessions. Participants could choose from various topics such as HIV care, mental health, relationships, sexuality, housing, and lifestyle. Then, they collaboratively work with the BHT to identify barriers to their HIV care and establish goals to overcome them. Participation in i2TEC requires being an HIV diagnosed adult not fully engaged in HIV care. Results Of the 50 participants enrolled in i2TEC, 84% were males, and 50% were non-Hispanic Whites. At baseline, 64% had a positive screen for substance use, 54% had a positive screen for depression or anxiety, and 71% did not have durable VS. Sixty percent had follow-up viral load labs, of which 97% had achieved VS within one-year post-enrollment. Participants' most identified discussion topics were lifestyle/health and socioeconomic needs (housing, food, and transportation). Overall, 95% would recommend the program, 86% agreed that i2TEC helped improve their mental health, and 76% reported that the program improved their medication adherence. Conclusion Preliminary findings from this tailored telehealth behavioral health program demonstrate feasibility and potential for improving HIV outcomes and overcoming individual barriers to VS. Through the delivery of i2TEC, we identified priority coaching needs among PWH. Future studies focusing on the topics identified by participants and the long-term impact of such programs are recommended. Disclosures Nada Fadul, MD, ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support

Proportion and Factors of Sex Communication Topics Among Parents of Sexual Minority Males

The topics parents talk about with their adolescent sexual minority male (ASMM), and the factors of parent-adolescent sex communication from the parents’ perspective are currently understudied. The purpose of this study was to examine the proportion and factors of parental communication about four different sexual health domains with their ASMM: sexual risk, biomedical prevention, relational, and expression. Parents across the United States (n = 115) completed an online cross-sectional survey in March 2023. We used a series of multiple logistic regressions to examine the associations between topic discussion and demographic and attitudinal correlates. More parents reported discussing sexual risk topics (e.g., condoms, HIV/AIDS and other STIs) than relational, expression, and biomedical prevention topics. Two common factors across sexual health domains were that cisgender women were more likely than cisgender men to have sexual health conversations with their ASMM, and those with more positive attitudes toward sexual health communication were more likely to have these conversations. Our findings have the potential to inform future parent-adolescent sex communication research and interventions.

P0343 Gender Identity and Inflammatory Bowel Disease: The Patient Perspective

Abstract Background The experience of transgender and gender non-conforming (TGNC) individuals in healthcare is under-researched particularly in relation to the impact of chronic diseases such as inflammatory bowel disease (IBD). IBD is believed to affect 1 in 123 individuals in the United Kingdom (UK)(1) and can have a profoundly negative impact upon both quality of life and mental health. However, the impact of the duality of suffering from IBD and identifying as TGNC is poorly understood and there is no data examining the experiences of these patient groups nor the specific challenges that they face when engaging with IBD healthcare services. We therefore aimed to explore the experiences of TGNC individuals with IBD (TGNC-IBD) in the UK healthcare system. Methods A literature review was performed to identify themes for discussion which were used to create an interview guide. Individuals who identified as TGNC and suffered from IBD were recruited through the charity Crohn’s and Colitis UK.(2) Participant information sheets were distributed to potential participants and once consented, an in-depth semi-structured focus group was performed with all participants. A second independent researcher reviewed the transcript and audio-visual recordings to ensure validity of the findings. Inductive thematic analysis was used to identify recurrent themes. Ethical approval was obtained from St. George’s University of London. Results Seventeen individuals contacted the team expressing interest in participating. Six respondents continued to engage and two pulled out on the preceding day. Four TGNC-IBD patients participated in the study with their demographics summarised in table 1. Six main themes emerged when discussing their experiences of healthcare encounters: 1. Healthcare professionals’ assumptions about gender identity 2. Inadequate mental health care provision 3. A lack of research and evidence-based practice specific to TGNC-IBD individuals 4. Distressing experiences due to gender-specific healthcare facilities 5. Transphobic comments from healthcare staff 6. The need for greater staff training. Participants reported that these factors contributed to negative healthcare experiences and exacerbated both the physical and mental health challenges they faced. Conclusion TGNC-IBD individuals face unique challenges that negatively affect their healthcare experiences. Key areas for improvement include increased staff training, the creation of gender-neutral facilities and more research into the interplay between a TGNC identity and IBD. Addressing these concerns will enhance the quality of care and improve patient experiences for this underserved minority.

Integrating general practitioners' and patients' perspectives in the development of a digital tool supporting primary care for older patients with multimorbidity: a focus group study.

The web application gp-multitool.de is based on the German clinical practice guideline "multimorbidity" and supports mutual prioritisation of treatments by GPs (general practitioners) and patients. The application facilitates sending hyperlinks to standardized assessments by email, which can be completed by patients on any suitable digital device. GPs can document clinical decisions. The tool also supports a structured medication review. Aims of this study were to consider needs and wants of the target groups in implementing the "multimorbidity" clinical practice guideline in a digital tool, and to examine themes of discussions in order to identify which aspects were considered most important for customising a digital tool. We conducted six focus groups with 32 GPs and six focus groups with 33 patients. Eight groups were conducted alongside the programming of the web application and four after finishing a prototype. GPs were recruited by mail and asked to invite up to six eligible patients from their practice to participate. Focus groups were based on semi-structured interview guides and discussed assessments, functionalities, usability and reliability of gp-multitool.de. Discussions were transcribed verbatim and analysed using content analysis. GPs wanted to avoid unnecessary and time-consuming functions and did not want to explore problems that they could not provide solutions for. For some assessments, GPs suggested simplifying scales or including residual categories. GPs and patients also addressed possible misunderstandings due to wording and discussed if some items might be too intimate or overtax patients intellectually. In most cases, participants confirmed usability, but they suggested changes in default settings and pointed out a few minor bugs that needed to be fixed. While some GPs considered data security an important topic, most patients were unconcerned with this issue and open to share their data. Our study indicates that focus groups can be used to customize a digital tool according to the needs and wants of target groups and thus, improve content, functionality, usability, and reliability of digital tools. However, digital tools still need to be piloted and evaluated in everyday care. In our focus groups, study participants confirmed that gp-multitool.de can be a relevant approach for overcoming deficits in the information needed for mutual prioritisation of treatments by GPs and patients.

Giving the outrage a name – how researchers are challenging employment conditions under the hashtags #IchBinHanna and #IchBinReyhan

ABSTRACT Outraged by the release of a ministerial video in which short-term employment contracts in German academia were lauded through the embodiment of fictitious doctoral researcher Hanna, thousands of researchers rallied behind the hashtags #IchBinHanna & #IchBinReyhan to vent their frustrations about precarious academic employment in Germany. The emerging connective action attracted a comparatively large number of researchers in a short period of time, stayed active for over two years, elicited reactions from policymakers and the media, and influenced current legislative developments in Germany. We analyse the discourse of over 45,000 tweets related to the movement from its onset in June 2021 to March 2023. Using a mixed-methods approach that combines machine-learning, corpus-linguistic, and qualitative analysis methods, we aim to distil the factors that led to the movement’s considerable success. The fast growth of the movement was likely driven by the use of an easy-to-personalise action frame and the large variety of discussion topics, facilitating the involvement of different groups of academics across career levels and employment conditions. Our analysis of the linguistic characteristics of the discourse reveals largely positive, constructive, and active exchanges, in which many of the most salient keywords are lexical verbs. Our analyses offer an explanation for the continued involvement of many activists and the successful translation of solutions developed by the movement to news reports and proposed law amendments, despite an absence of coordination by any formal organisation.

Sentiment Analysis of the Influence of the Korean Wave in Indonesia using the Naive Bayes Method and Support Vector Machine

This study analyzes public sentiment towards the influence of the Korean wave in Indonesia using the Naive Bayes and Support Vector Machine (SVM) methods. The Korean wave, as a popular cultural phenomenon from South Korea, has had a significant influence on various aspects of Indonesian society. The dataset consists of 6,327 tweets obtained through a crawling process on social media X, with 80% data divided for training and 20% for testing. The pre-processing process includes cleaning, case folding, tokenizing, stopwords, and stemming. Data imbalance in sentiment distribution is overcome by the SMOTE technique. The test results show that the SVM model has the highest accuracy of 89%, outperforming the Naive Bayes model with an accuracy of 81%. Performance evaluation using precision, recall, and F1-score shows that SVM is more consistent in classifying positive and negative sentiments. Data visualization is done using bar charts and word clouds to illustrate the main patterns and themes in discussions related to the Korean wave in Indonesia. However, this study has limitations, such as data is only taken from one social media platform, so the results are less representative of public opinion as a whole. Nevertheless, this study provides new insights into how Indonesian society responds to popular culture phenomena online. These findings can also be utilized by policymakers to support the development of creative industries based on popular culture.

Development of the Lee Symptom Scale-Skin Sclerosis for chronic GVHD-associated sclerosis.

Sclerosis is a highly morbid manifestation of chronic GVHD (cGVHD), associated with distressing symptoms and significant long-term disability. A patient-reported outcome measure (PRO) for cGVHD-associated sclerosis is essential to advance therapeutic trials. We aimed to develop a PRO for adults with cGVHD-associated sclerosis and evaluate and refine its content validity. Adults age ≥18 years with cGVHD-associated sclerosis participated in semi-structured interviews to identify salient symptoms and functions. Sclerosis-relevant symptoms and functions from existing PROs were also used to prompt discussion of topics not spontaneously mentioned. Symptoms and functions (subcodes) of importance were clustered and mapped to overarching domains (codes) using inductive analysis, and candidate items were developed. Cognitive interviews were employed to evaluate content validity of the items, response options, recall period, and respondent instructions.Thirty-five open-ended interviews, conducted to saturation, revealed the breadth of the patient experience with cGVHD-associated sclerosis including 5 overarching domains: (1) skin changes, (2) symptoms, (3) emotional and social functioning, (4) mobility restrictions, and (4) activity limitations. A pool of 54 items was tested and iteratively refined through cognitive debriefing interviews (n=25). Phrasing changes were made to improve relevance and comprehension. One item was removed and two items were added to address respondent feedback, resulting in 55 items. Results support the relevance, comprehensibility, and comprehensiveness of the provisional Lee Symptom Scale-Skin Sclerosis. Concept elicitation and cognitive interviewing have informed the development of the Lee Symptom Scale-Skin Sclerosis. Psychometric testing and determination of minimal clinically important difference are underway in an external cohort to validate the PRO.

Measuring trends in extinction risk: a review of two decades of development and application of the Red List Index.

The Red List Index (RLI) is an indicator of the average extinction risk of groups of species and reflects trends in this through time. It is calculated from the number of species in each category on the IUCN Red List of Threatened Species, with trends influenced by the number moving between categories when reassessed owing to genuine improvement or deterioration in status. The global RLI is aggregated across multiple taxonomic groups and can be disaggregated to show trends for subsets of species (e.g. migratory species), or driven by particular factors (e.g. international trade). National RLIs have been generated through either repeated assessments of national extinction risk in each country or through disaggregating the global index and weighting each species by the proportion of its range in each country. The RLI has achieved wide policy uptake, including by the Convention on Biological Diversity and the United Nations Sustainable Development Goals. Future priorities include expanding its taxonomic coverage, applying the RLI to the goals and targets of the Kunming-Montreal Global Biodiversity Framework, incorporating uncertainty in the underlying Red List assessments, integrating into national RLIs the impact of a country on species' extinction risk abroad, and improving analysis of the factors driving trends.This article is part of the discussion theme issue 'Bending the curve towards nature recovery: building on Georgina Mace's legacy for a biodiverse future'.

Mapping out strategies to further develop human-relevant, new approach methodology (NAM)-based developmental neurotoxicity (DNT) testing.

On occasion of the DNT5 meeting in Konstanz, Germany (April-2024), participants brainstormed on future challenges concerning a regulatory implementation of the developmental neurotoxicity (DNT) in vitro test battery (DNT-IVB). The five discussion topics below outline some of the key issues, opportunities and research directions for the next several years: (1) How to contextualize DNT hazard with information on potential maternal toxicity or other toxicity domains (non-DNT)? Several approaches on how to use cytotoxicity data from NAMs were discussed. (2) What opportunities exist for an immediate or near-future application of the DNT-IVB, e.g. as a prioritisation step or add-on to other information? Initial examples are already emerging; the data can be used even if the battery is not converted to a defined approach. (3) How to establish data interpretation procedures for multi-dimensional endpoints that reduce dimensionality and are suitable for classification? A decision framework is required on how to use the DNT-IVB in a regulatory context. Machine-learning (AI-approaches) may provide novel classification models. (4) How can a battery of molecular initiating events (MIEs) be smartly linked to the DNT-IVB? If decisions are required, at what tier of an overall strategy would MIEs be evaluated, and how would optimally balance cost vs information yield. (5) What is the way forward to scientific validation of DNT NAMs and the DNT-IVB? A large set of animal data would be required for conventional approaches, while mechanistic information may establish relevance in other ways.

Bibliometric Analysis of Alzheimer's Disease and Depression.

The link between Alzheimer's disease and depression has been confirmed by clinical and epidemiological research. Therefore, our study examined the literary landscape and prevalent themes in depression-related research works on Alzheimer's disease through bibliometric analysis. Relevant literature was identified from the Web of Science core collection. Bibliometric parameters were extracted, and the major contributors were defined in terms of countries, institutions, authors, and articles using Microsoft Excel 2019 and VOSviewer. VOSviewer and CiteSpace were employed to visualize the scientific networks and seminal topics. The analysis of literature utilised 10,553 articles published from 1991 until 2023. The three countries or regions with the most publications were spread across the United States, China, and England. The University of Toronto and the University of Pittsburgh were the major contributors to the institutions. Lyketsos, Constantine G., Cummings, JL were found to make outstanding contributions. Journal of Alzheimer's Disease was identified as the most productive journal. Furthermore, "Alzheimer's", "depression", "dementia", and "mild cognitive decline" were the main topics of discussion during this period. Data were searched from a single database to become compatible with VOSviewer and CiteSpace, leading to a selection bias. Manuscripts in English were considered, leading to a language bias. Articles on "Alzheimer's" and "depression" displayed an upward trend. The prevalent themes addressed were the mechanisms of depression-associated Alzheimer's disease, the identification of depression and cognitive decline in the early stages of Alzheimer's, alleviating depression and improving life quality in Alzheimer's patients and their caregivers, and diagnosing and treating neuropsychiatric symptoms in Alzheimer. Future research on these hot topics would promote understanding in this field.

Construção e validação de instrutivo para o cuidado nutricional da pessoa com obesidade grave no Sistema Único de Saúde

Abstract This article describes the construction and validation of an instruction manual geared toward nutritional care (NC) for people with severe obesity in the Brazilian Unified Health System (SUS). In the production of this instruction manual, a broad literature review was conducted for the identification and discussion of topics to be treated. The content and appearance validity were conducted according to the Delphi technique and to focus groups, respectively, with evaluators who were nutritionists and practitioners, from different regions of Brazil. According to the Delphi technique, the instruction attributes and their content as a whole were properly and sufficiently evaluated according to values obtained for the Content Validity Index (CVI &gt; 0.8). In the focus groups, the saturation of content was reached. Furthermore, discussions considering the reality of SUS were conducted and subsequently incorporated into the instructions in order to adequate the final version of the instructions to SUS professionals’ needs. In conclusion, the instruction manual produced to fill the gap regarding nutritional care for people with severe obesity presents an adequate content in terms of both quality and topics of interest (content validation), and is applicable within the reality of SUS nutritionists (appearance validity).

Construction and validation of an instruction manual of nutritional care for severely obese people in the Unified Health System.

This article describes the construction and validation of an instruction manual geared toward nutritional care (NC) for people with severe obesity in the Brazilian Unified Health System (SUS). In the production of this instruction manual, a broad literature review was conducted for the identification and discussion of topics to be treated. The content and appearance validity were conducted according to the Delphi technique and to focus groups, respectively, with evaluators who were nutritionists and practitioners, from different regions of Brazil. According to the Delphi technique, the instruction attributes and their content as a whole were properly and sufficiently evaluated according to values obtained for the Content Validity Index (CVI > 0.8). In the focus groups, the saturation of content was reached. Furthermore, discussions considering the reality of SUS were conducted and subsequently incorporated into the instructions in order to adequate the final version of the instructions to SUS professionals' needs. In conclusion, the instruction manual produced to fill the gap regarding nutritional care for people with severe obesity presents an adequate content in terms of both quality and topics of interest (content validation), and is applicable within the reality of SUS nutritionists (appearance validity).

Unmasking deception: a topic-oriented multimodal approach to uncover false information on social media

In the digital landscape, social media has emerged as a prevalent channel for global communication, connecting like-minded individuals worldwide. However, while facilitating information exchange, it is also susceptible to the dissemination of false information, posing a constant challenge to the reliability of online content. To address this issue, this paper introduces a novel methodology called TM-FID (Topic-oriented Multimodal False Information Detection), which combines false information detection and neural topic modeling within a semi-supervised multimodal approach. By jointly leveraging textual and visual information contained in online news, our approach provides insights into how false information influences specific discussion topics, thus enabling a comprehensive and fine-grained understanding of its spread and impact on social media conversation. Experimental evaluation carried out on a set of multimodal gossip-related news demonstrates the quality of the identified topics, assessed through a novel centroid-based metric, as well as the efficacy of the cross-attention mechanism used within TM-FID to accurately identify false information in multimodal news. Overall, the proposed methodology can enable effective strategies to counter the spread of false information, thereby fostering trust and confidence in the information shared on social media platforms.

Concluding remarks: Faraday Discussion on data-driven discovery in the chemical sciences.

This Faraday Discussion was the first to focus on the increasingly central role of big data, machine learning, and artificial intelligence in the chemical sciences. The aim was to critically discuss these topics, and to explore the question of how data can enable new discoveries in chemistry, both now and in the future. The programme spanned computational and experimental work, and encompassed emerging topics such as natural language processing, machine-learned potentials, optimization strategies, and robotics and self-driving laboratories. Here I provide some brief introductory comments on the history of this field, along with some personal views on the discussion topics covered, concluding with three future challenges for this area.

The impact of environmental literacy on the health level of rural residents: evidence from the mountainous areas of Sichuan, China.

Environmental pollution and health issues are hot topics of discussion in modern society. However, there is a lack of research from the perspective of subjective factors such as environmental protection to study the impact of environmental literacy on health, especially in rural areas. First, through field research in the mountainous rural areas of Sichuan Province, 396 data points were collected. Based on the KAP model, we constructed an interactive impact mechanism model for the health of rural residents. We used chi-square tests and t-tests to examine the relationship between the background characteristics of rural residents and environmental protection. All environmental literacy variables were classified into strong and weak observational variables, and a multiple linear regression model was employed to explore the impact mechanism of environmental literacy (divided into environmental protection awareness, attitudes, behaviors, and perceptions of environmental pollution) on the health of rural residents. (1) Young village officials with higher education levels are more likely to have stronger environmental literacy. (2) The health status of rural residents is positively affected by their positive attitude towards environmental protection and negatively affected by their environmental protection behaviors. (3) Age, gender, marital status, and party membership have a significant impact on the health of rural residents. The results of this study can enhance the attention to the living environment and health in rural areas, and provide a scientific basis for improving the environmental literacy and health level of rural residents.

Exercise-induced bronchoconstriction in children: Delphi study and consensus document about definition and epidemiology, diagnostic work-up, treatment, and follow-up

BackgroundExercise-induced bronchoconstriction (EIB) is common in children with asthma but can be present also in children without asthma, especially athletes. Differential diagnosis includes several conditions such as exercise-induced laryngeal obstruction (EILO), cardiac disease, or physical deconditioning. Detailed medical history, clinical examination and specific tests are mandatory to exclude alternative diagnoses. Given the high prevalence of EIB in children and its potential impact on health, sport performance, and daily levels of physical activity, health care professionals should be aware of this condition and able to provide a specific work-up for its identification. The aims of the present study were: (a) to assess the agreement among hospital pediatricians and primary care pediatricians of Emilia-Romagna Region (Italy) about the management of EIB in children and (b) formulate statements in a consensus document to help clinicians in daily clinical practice.MethodsAccording to Delphi method, a panel of specialists scored 40 statements that were then revised and discussed during online meetings to reach full consensus. Statements were then formulated.ResultsTo obtain full consensus, the questionnaire was administered in two rounds after full discussion of the uncertain topics on the basis of the latest evidence on EIB published over the last 10 years. Despite an overall agreement on EIB management, some gaps emerged in the sections dedicated to diagnosis and treatment. Nine summary statements on definition, pathogenesis, diagnostic work-up, treatment, and follow-up were eventually formulated.ConclusionsThis study describes the knowledge of EIB in a group of pediatricians and highlights gaps and uncertainties in diagnosis and treatment. The creation of statements shared by the specialists of the same area may improve the management of EIB in children. However, more research and evidence are needed to better clarify the best treatment and to standardize the best diagnostic protocol limiting useless examinations but at the same time assuring the best management.