A practice game changer: Impact of tenecteplase for acute ischemic stroke in a multicenter quality improvement project

Purpose Tenecteplase is a thrombolytic that is more fibrin specific, has a longer half-life, and is easier to administer than alteplase for acute ischemic stroke (AIS). This article outlines the pharmacy experience and perspective on implementation of tenecteplase as the treatment of choice for AIS. Summary Tenecteplase has been of increasing interest for AIS and is currently being studied in several clinical trials. Although it is not indicated by the Food and Drug Administration for AIS, several published studies and an update to stroke guidelines from the American Heart Association and American Stroke Association support its use in this setting. In January 2021, Cedars-Sinai Health System made the decision to add tenecteplase to the formulary for AIS in addition to keeping alteplase for patients who met the criterion of being outside the 4.5-hour window following stroke onset. Along with the added benefits of having tenecteplase on formulary come challenges of managing multiple thrombolytics for the same indication. Identifying key stakeholders and creating an interdisciplinary team are critical to ensure safe transitions. Conclusion Institutions can safely transition from alteplase to tenecteplase as a thrombolytic of choice for AIS.

Co-authors, colleagues, and contributors: Complications in collaboration and sharing lessons on academic writing

Academic writing, especially in the health field, is usually an interdisciplinary team effort. This paper highlights some of the trials, tribulations, and benefits of working with co-authors. This includes collaborations and co-authorship between academics from different disciplines, academics of different level of careers, and authors from countries of varying economies i.e., high-income countries (HICs) and from low-and middle-income countries (LMICs). This paper also provides advice in the form of several useful tips to lead authors and co-authors to support collaborative working.

Are Oropharyngeal Dysphagia Screening Tests Effective in Preventing Pneumonia?

Oropharyngeal dysphagia, a clinical condition that indicates difficulty in moving food and liquid from the oral cavity to the esophagus, has a markedly high prevalence in the elderly. The number of elderly people with oropharyngeal dysphagia is expected to increase due to the aging of the world’s population. Understanding the current situation of dysphagia screening is crucial when considering future countermeasures. We report findings from a literature review including citations on current objective dysphagia screening tests: the Water Swallowing Test, Mann Assessment of Swallowing Ability, and the Gugging Swallowing Screen. Pneumonia can be predicted using the results of the screening tests discussed in this review, and the response after the screening tests is important for prevention. In addition, although interdisciplinary team approaches prevent and reduce aspiration, optimal treatment is a challenging. Intervention studies with multiple factors focusing on the elderly are needed.

Serious Game Design by Unified Block Interactions to Support Educational Transformations

This paper introduces a generalized structure for the optimal development of an adventure serious game. Present pandemic conditions induce transformations in educational methods, of which games are an attractive option. A serious game is an interdisciplinary team project for which our structure allows all members to interact irrespective of computer science proficiency. A method of interaction between unified blocks is proposed, consisting of five blocks that cover all the characteristics necessary to describe a serious game. The unified blocks are: rules, characters, scenarios, communication and score. The blocks are divided into sub-blocks that detail the characteristics of the game. The “luck” sub-block allows the real-life non-predictability dimension to be included in the game. During the interaction of the sub-blocks the different contexts of the game are created. Each context has a specific educational content goal that the player must go through. The interactions between sub-blocks are described in an XML file, common working environment for all the interdisciplinary members of the design team involves graphic designers, programmers, game designers and experts in the content to be transmitted. The principle of unified blocks is applied to the fifteen contexts of an existing game, JUSEGU, for which five new contexts are included and implemented in this paper to increase its educational content.

Prosthodontic Rehabilitation of Hypodontia – A Team Approach

Hypodontia can have an impact on speech, aesthetics, function and psycho-social behavior of individuals afflicted by the problem. Rehabilitation of patients with hypodontia usually requires complex treatment planning, depending upon the pattern of tooth absence, amount of residual spacing, presence of malocclusion and patient compliance. It is an interdisciplinary intervention, involving prosthodontists, orthodontists, oral surgeons, speech pathologists and psychologists to achieve an optimal outcome for the patient. This case report describes the close work of a committed team from orthodontic, oral surgery and prosthodontic department of de'Montmorency College of Dentistry, Lahore, to reach final aesthetic and functional outcomes for an 18 year old girl with oligodontia. Her chief complaint was poor esthetics and absence of multiple anterior teeth with unsightly spacing between remaining teeth. Orthodontic redistribution of spaces followed by fixed full arch prosthetic rehabilitation were the goals achieved at the end of her treatment. KEYWORDS: Oligodontia, interdisciplinary team work, prosthodontic rehabilitation, fixed restorations.

Opere moltiplicate, opera aperta Serialità e anonimato nelle ricerche cinevisuali degli anni Sessanta

In the early 1960s, groups of artists begin to develop collective research in kinetic art and visual perception. By combining art, industrial design and technology, these ‘aesthetic operators’ lay the foundations for a multiplied art, made for everybody. The aim of their work is to open art to a genuine democratization process since the viewer would interact with these manipulable objects. However, this point of view questions the art myth of the ‘unique and unrepeatable’ artwork, which is replaced by the ‘open work’, produced in series by an interdisciplinary team. Moreover, the theory of anonymity and the multiples increase the critical debate concerning the concept of authenticity. The paper proposes a reflection on the diffusion of multiplied art during the 1960s. Through the analysis of the archival documents – some previously unpublished – the study identifies the crucial passages in which the experimentations of programmed Italian artists have embraced the democratic ideology of seriality.

The multiple sclerosis patient’s journey model in Poland – future tasks

Improvement of the diagnostic and therapeutic processes and optimal use of resources in the context of health care system specificity accelerate the diagnosis and treatment onset, as well as improve the quality of life of patients with multiple sclerosis. International experience and data from clinical practice in Poland gave rise to a number of guidelines for the needed measures, from increasing the awareness about multiple sclerosis among the society and doctors in general, through expanding outpatient medical care, to proposing a model network of healthcare centres dedicated to patients with multiple sclerosis. It was pointed out that there is a need for a network of clinics specialised in the diagnosis and treatment of multiple sclerosis (MS clinics) and centres for comprehensive diagnosis and treatment, with a higher reference level and all the competences of an MS clinic, and, at the same time, providing both consultations in difficult clinical cases and access to the most advanced diagnostic and therapeutic methods. Attention was also drawn to the need to use modern e-health tools, which should improve the diagnostic and therapeutic process, as well as tighten the coordination of care by enabling an effective exchange of information between the patient and the entire interdisciplinary team involved in the therapeutic process.

The Cambridge Companion to Cicero's Philosophy

Cicero is one of the most important and influential thinkers within the history of Western philosophy. For the last thirty years, his reputation as a philosopher has once again been on the rise after close to a century of very low esteem. This Companion introduces readers to 'Cicero the philosopher' and to his philosophical writings. It provides a handy port-of-call for those interested in Cicero's original contributions to a wide variety of topics such as epistemology, the emotions, determinism and responsibility, cosmopolitanism, republicanism, philosophical translation, dialogue, aging, friendship, and more. The international, interdisciplinary team of scholars represented in this volume highlights the historical significance and contemporary relevance of Cicero's writings, and suggests pathways for future scholarship on Cicero's philosophy as we move through the twenty-first century.

Promoting Intergenerational Justice Through Participatory Practices: Climate Workshops as an Arena for Young People’s Political Participation

In the fall of 2019, Trøndelag County Council, Norway, organized a Climate Workshop for children and youth. The intention of the workshop was to include children’s and youth’s perspectives as a foundation for a policy document titled “How we do it in Trøndelag. Strategy for transformations to mitigate climate change”. The workshop involved a range of creative and discussion tools for input on sustainable development and climate politics. In this article, we aim to (1) describe and discuss innovative practices that include children and youth in policymaking related to climate action, and (2) discuss the theoretical implications of such policymaking in relation to children’s rights, young citizenship, and intergenerational justice. We employ a generational framework and perceive climate politics as inherently ingrained in intergenerational justice, where no generation has a superior claim to the earth’s resources, yet power is unfairly concentrated and accumulated among adult generations. We draw on contributions by various stakeholders involved: Two young workshop participants, two county council policymakers, and an interdisciplinary team of researchers from Childhood Studies and Design.