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Abstract Background We have previously shown that the bronchodilatory effect of deep inspiration is attenuated in individuals with COPD. This study was designed to investigate whether the impairment in this effect is associated with loss of alveolar attachments. Methods We measured deep inspiration (DI)-induced bronchodilation in 15 individuals with and without COPD (67 ± 2.2 yrs of age, mean ± SEM) undergoing lobar resection for peripheral pulmonary nodule. Prior to surgery, we measured TLCO and determined the bronchodilatory effect of deep inspiration after constricting the airways with methacholine. The number of destroyed alveolar attachments, as well as airway wall area and airway smooth muscle area, were determined in tumor-free, peripheral lung tissue. Results The bronchodilatory effect of deep inspiration correlated inversely with the % destroyed attachments (r = -0.51, p = 0.05) and directly with the airway smooth muscle area (r = 0.59, p = 0.03), but not with the total wall area (r = 0.39, p = 0.15). Conclusion We postulate that attenuation of airway stretch due to loss of alveolar attachments contributes to the loss of the bronchodilatory effect of lung inflation in COPD.

Background and Objectives: The disruption of the intestinal epithelial barrier leads to increased intestinal permeability (IP), allowing endotoxins and pathogens to enter the bloodstream contributing to chronic inflammation. Western diets are associated with increased IP, while diets rich in polyphenols, fiber, and omega-3 fats are linked to decreased IP. The relationship between diet, disease activity, and IP in ulcerative colitis (UC) is poorly understood. We evaluated the effects of serum zonulin and lipopolysaccharide-binding protein (LBP) and their relationship to dietary factors in UC. Methods: A cross-sectional analysis was conducted on 37 UC participants who had baseline measures of dietary intake, disease activity and serum. Serum LBP and zonulin levels were measured by ELISA. Spearman's rank correlations explored relationships between baseline IP, diet, and disease activity. Results: The median age was 35 years (29–47 years), 54% were male, and 76% were in clinical remission or had mild disease activity (partial Mayo score ≤ 4). LBP was significantly correlated (p < 0.05) with disease activity (partial Mayo score (r = 0.31), and positively correlated with total fat (r = 0.42) and refined grains (r = 0.35), but negatively correlated with fruit consumption (r = −0.50) and diet quality (r = −0.33). Zonulin was negatively correlated with protein (r = −0.39), niacin (r = −0.52) and vitamin B12 (r = −0.45) with a trend for significance (p = 0.06) with body mass index (r = 0.32). Conclusions: Baseline LBP levels were correlated with disease activity markers and dietary factors, suggesting that it could be a useful biomarker for assessing disease activity and diet quality in UC. Further trials are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

In recent years, there has been a noticeable increase in attention towards promoting well-being within academic settings. In the specific context of academia, a critical issue is understanding whether the current practices for assessing and managing well-being can bridge the implementation gap and increase opportunities for creating healthy academic conditions. The paper explores the practices adopted for assessing and managing work-related stress (WRS) risks in Italian academia by referring to data from a group of Italian universities of the QoL@Work network (Quality of Life at Work in academia). The aim is to improve understanding of the factors that influence the realization of a WRS risk assessment-management pathway and how they may facilitate or hinder the transition from assessment to the implementation of interventions in the academic context. The results suggest that the assessmentmanagement pathway should prioritize the creation of organizational scaffolding to support participatory processes in order to prevent the data collected from failing to stimulate organizational change in working conditions. [ABSTRACT FROM AUTHOR]

Sustaining students in becoming reflective practitioners is considered as a valued outcome of higher education. The paper aims to evaluate the impact of the learning environment conditions inspired by Schön's theory of reflective practicum, by discussing a case study of a master's degree class. The learning environment was designed to sustain reflective practice and meaningful engagement through professional practice simulation, problem-based learning and reflective writing. Unlike much of the research into reflective learning, the quality of learning was evaluated by assessing the use of reflective practice in students' weekly journaling, rather than measuring students' satisfaction or perceptions of effectiveness. Two hundred and six journal entries of 23 students were assessed and used in a quantitative analysis based on a linear mixed-effects model. Findings indicated that the reflective practicum has an incremental effect on students' reflective practices and that reflective practice is dynamic and sensitive to specific learning environment conditions. In conclusion, students' co-responsibility of the learning environment allowed by the professional practice simulation appears to foster meaningful and reflective learning. Conversely, conditions that stimulate only cognitive engagement have little impact or even inhibit reflective practices. Practical implications of the use of reflective journal are discussed.

Critical reflexivity has been acknowledged as fundamental in higher education. For facing complex situations in turbulent environments, students nowadays need not only to be taught technical knowledge, but also to be helped develop "relevant" learning for their future professional practice. In recent years, scholars have concentrated on what makes the internship experience a successful opportunity for the parties involved, and have also discussed the crucial role of a mentor/tutor in sustaining relevant and effective learning. However, the specific conditions that make tutorship successful in promoting critical reflexivity in such a boundary crossing experience need to be further explored. Aim of this paper is therefore to analyze what tutorship conditions sustain the development of critical reflexivity in internship. For this purpose, we will present the case study of an internship program run by one of the largest universities in northern Italy.

Reflective journals have emerged as an effective means of monitoring and developing reflective practice in higher education, as part of a wider metacognitive strategy to transform traditional learning approaches. In addition, assessment procedures of reflective journals appear to be an important factor in enhancing commitment to learning and reflection. This paper explores the effects of the use of journal writing and formative feedback on the quality of reflective practice, by presenting a case study of reflective learning in a master's degree program in the North of Italy, in 2014/2015. The article contributes to the current debate about the effectiveness of one-to-one writing tuition by analyzing student writing through qualitative analysis and quantitative trend assessment. In particular, it provides evidence on formative feedback efficacy in developing the quality of reflective practice. Unlike much of the research into writing support, this study seeks to evaluate the impact of feedback use not only by measuring student perceptions of effectiveness or level of satisfaction, but also by assessing the development of reflective practices.

Reflexivity is a primary requirement for professional work. Our aim was to describe a methodology suitable for detecting the development of reflexive practice through the analysis of 59 Master's degree students' journals. We explore the use and changes of reflexive practice in relation to the settings and activities of the course using analysis of the mental language: We analyse how the reflexive practice is characterized, how it evolves through time and how it can be promoted. Data analysis shows that reflexivity is not monodimensional but multidimensional. Reflexive practice increases during the course: The different dimensions vary over time according to different organizational and educational conditions. This methodology allows us to formulate new hypotheses about which elements of the setting and process are effective in supporting participants' reflexive practice.

Adipose tissue is an endocrine organ that interferes with the severity of chronic obstructive pulmonary disease (COPD). Although inflammatory markers, body composition, and nutritional status have a significant impact on pulmonary function, the real contribution of adipocytokines and myokines in COPD is still controversial. We aimed to evaluate the role played by the body composition, leptin, adiponectin, haptoglobin, and irisin on the functional exercise capacity, respiratory function, and quality of life (QoL) in COPD. In 25 COPD (20% GOLD-1; 60% GOLD-2; 20% GOLD-3) patients and 26 matched control subjects, we find that leptin, total adiponectin and haptoglobin are significantly increased whereas the 6 min walk test (6MWT) and physical functioning scores are significantly decreased in COPD versus controls. A significant positive relationship is found between leptin and fat mass and between 6MWT and the good health indicators of nutritional status. A significant inverse relationship is found between 6MWT and leptin and fat mass, FEV1 and haptoglobin, and irisin and haptoglobin. Phase angle and leptin level are significant predictors for functional exercise capacity assessed with 6MWT. Taken altogether, the results of this pilot study further support the role played by body composition and adipocytokines on exercise capacity respiratory function and QoL in COPD. [ABSTRACT FROM AUTHOR]