Caratterizzazione tipologica dei rapporti tra fenomeni di desertificazione ed acque superficiali e sotterranee, osservati e studiati in Sardegna

This study has been carried out within a broader research project, RIADE, concerned with the characterization of the types of relationships existing between desertification processes and surfaceand groundwater observed and investigated in Objective 1 regions. The underlying assumption is that the deteriorating quality and diminishing quantity of a region’s water resources impact negatively on the development of all living things and on human organization, and thus represent a basic indicator of desertification, intended in its broadest sense as the degradation of bioproductive land. By re-processing the scientific results obtained for Sardinia during this project, we have developed a reference framework for the systematic representation of the types found, qualitatitive/quantitative natural or anthropogenic degradation phenomena/processes of water resources in Sardinia. Two distinct criteria have been adopted for the typological categorization of the deteriorating quality and diminishing quantity of water, both divorced from the environmental and regional context in which they occur.The first criterion is based on an analysis of water quantity and quality and on the “pollutant type”, along the lines suggested by the Italian Research Council’s National Group for Hydrogeological Disaster Protection (GNDCI); the second criterion uses the DPSIR model adopted by the European Environmental Agency (EEA), which defines five indicator categories for the state and evolution of the environmen

Construcción y validación de la Escala de Comunicación Interprofesional en Salud

To construct and validate the Interprofessional Communication Scale in Health. Methods: a psychometric study was carried out on a sample of 360 nurses from a hospital and university center in central Portugal. Reliability was assessed through internal consistency and construct validity through exploratory and confirmatory factor analysis. Results: the Interprofessional Communication in Health Scale, consisting of 27 items, is organized into 3 factors: "Teamwork", "Conflict management" and "Leadership", with a total variance of 51.1%. Good internal consistency was obtained, with a Cronbach's alpha of 0.842, and adequate Goodness of Fit Index model. Conclusions:the Interprofessional Communication in Health Scale presents a factorial structure with adequate validity and reliability results, and may constitute a useful self-report instrument in assessing interprofessional communication in healthConstruir e validar a Escala de Comunicação Interprofissional em Saúde. Métodos: o estudo psicométrico foi realizado em uma amostra com 360 enfermeiros de um centro hospitalar e universitário da região centro de Portugal. A confiabilidade foi avaliada através da consistência interna e a validade do construto pela análise fatorial exploratória e confirmatória. Resultados: a Escala de Comunicação Interprofissional em Saúde, constituída por 27 itens, está organizada em 3 fatores: “Trabalho em equipe”, “Gestão de conflitos” e “Liderança”, com uma variância total de 51,1%. Obtiveram-se boa consistência interna, com alfa de Cronbach de 0,842, e índices adequados de qualidade de ajustamento do modelo. Conclusões: a Escala de Comunicação Interprofissional em Saúde apresenta uma estrutura fatorial com resultados adequados de validade e de confiabilidade, podendo constituir-se um instrumento de autorresposta útil na avaliação da comunicação interprofissional em saúdeConstruir y validar la Escala de Comunicación Interprofesional en Salud. Métodos: el estudio psicométrico se realizó sobre una muestra de 360 enfermeras de un centro hospitalario y universitario del centro de Portugal. La confiabilidad se evaluó a través de la consistencia interna y la validez de constructo mediante análisis factorial exploratorio y confirmatorio. Resultados: la Escala de Comunicación Interprofesional en Salud, compuesta por 27 ítems, se organiza en 3 factores: “Trabajo en equipo”, “Gestión de conflictos” y “Liderazgo”, con una varianza total del 51,1%. Se obtuvo una buena consistencia interna, con un alfa de Cronbach de 0,842, y adecuados índices de bondad de ajuste del modelo. Conclusiones: la Escala de Comunicación Interprofesional en Salud presenta una estructura factorial con resultados adecuados de validez y confiabilidad, pudiendo constituir un instrumento de autoinforme útil en la evaluación de la comunicación interprofesional en salu

Fate of β-blockers in aquifer material under nitrate reducing conditions: Batch experiments

      The fate of the three environmentally relevant β-blockers atenolol, metoprolol and propranolol has been studied in batch experiments involving aquifer material and nitrate reducing conditions. Results from the about 90 d long tests indicate that abiotic processes, most likely sorption, jointly with biotransformation to atenololic acid were responsible for the 65% overall removal observed for atenolol. Zero order kinetics, typical of enzyme-limited reactions, controlled the transformation of this beta blocker to its corresponding carboxylic acid. The mass balance evidences that no mineralization of atenolol occurs in the biotic experiment and that atenololic acid is more stable than its parent compound under the studied conditions. This finding stresses the importance of considering atenololic acid as target compound in the environmental studies on the fate of atenolol. For metoprolol and propranolol the results from the experiment suggest a slower sorption to be the dominant removal process, which led to final decreases in concentrations of 25–30% and 40–45%, respectively. Overall, the removals observed in the experiments suggest that subsurface processes potentially constitute an alternative water treatment for the target beta-blockers, when compared to the removals reported for conventional wastewater treatment plants. &nbsp

Cultura de segurança do doente na prática clínica dos enfermeiros

Objective: to assess the psychometric characteristics of the Hospital Survey on Patient Safety Culture, to characterize the patient safety culture, and to assess the influence of the sociodemographic and professional variables on the safety culture dimensions. Method: a methodological, observational, analytical and cross-sectional study conducted with 360 nurses in which the Hospital Survey on Patient Safety Culture questionnaire was used. The data were submitted to descriptive and inferential analysis, as well as to feasibility and validity studies. Results: the nurses’ mean age is 42 years old, their mean time of professional experience is 19 years, and they are mostly female. Good internal consistency was obtained (Cronbach’s alpha: 0.83), as well as acceptable model fit quality indices. Teamwork within units, Supervisor expectations and Feedback and communication about errors were the dimensions that obtained scores above 60%. Non-punitive response to error, Frequency of events reported, Support for patient safety and Staffing presented scores below 40%. These dimensions are influenced by age, schooling level and professional experience. Conclusion: the psychometric properties of the questionnaire certify its good quality. Teamwork can be considered as an enhancing factor for the safety culture. Assessing the safety culture allowed identifying problematic dimensions, thus enabling planning of future interventions.info:eu-repo/semantics/publishedVersio

Biological and Biochemical Basis of the Differential Efficacy of First and Second Generation Somatostatin Receptor Ligands in Neuroendocrine Neoplasms

Endogenous somatostatin shows anti-secretory effects in both physiological and pathological settings, as well as inhibitory activity on cell growth. Since somatostatin is not suitable for clinical practice, researchers developed synthetic somatostatin receptor ligands (SRLs) to overcome this limitation. Currently, SRLs represent pivotal tools in the treatment algorithm of neuroendocrine tumors (NETs). Octreotide and lanreotide are the first-generation SRLs developed and show a preferential binding affinity to somatostatin receptor (SST) subtype 2, while pasireotide, which is a second-generation SRL, has high affinity for multiple SSTs (SST5 > SST2 > SST3 > SST1). A number of studies demonstrated that first-generation and second-generation SRLs show distinct functional properties, besides the mere receptor affinity. Therefore, the aim of the present review is to critically review the current evidence on the biological effects of SRLs in pituitary adenomas and neuroendocrine tumors, by mainly focusing on the differences between first-generation and second-generation ligands

Patient safety culture in nurses' clinical practice

Objective: to assess the psychometric characteristics of the Hospital Survey on Patient Safety Culture, to characterize the patient safety culture, and to assess the influence of the sociodemographic and professional variables on the safety culture dimensions. Method: a methodological, observational, analytical and cross-sectional study conducted with 360 nurses in which the Hospital Survey on Patient Safety Culture questionnaire was used. The data were submitted to descriptive and inferential analysis, as well as to feasibility and validity studies. Results: the nurses’ mean age is 42 years old, their mean time of professional experience is 19 years, and they are mostly female. Good internal consistency was obtained (Cronbach’s alpha: 0.83), as well as acceptable model fit quality indices. Teamwork within units, Supervisor expectations and Feedback and communication about errors were the dimensions that obtained scores above 60%. Non-punitive response to error, Frequency of events reported, Support for patient safety and Staffing presented scores below 40%. These dimensions are influenced by age, schooling level and professional experience. Conclusion: the psychometric properties of the questionnaire certify its good quality. Teamwork can be considered as an enhancing factor for the safety culture. Assessing the safety culture allowed identifying problematic dimensions, thus enabling planning of future interventions

Ethical safety of deep brain stimulation: A study on moral decision-making in Parkinson's disease

INTRODUCTION: The possibility that deep brain stimulation (DBS) in Parkinson's disease (PD) alters patients' decisions and actions, even temporarily, raises important clinical, ethical and legal questions. Abnormal moral decision-making can lead to ethical rules violations. Previous experiments demonstrated the subthalamic (STN) activation during moral decision-making. Here we aim to study whether STN DBS can affect moral decision-making in PD patients. METHODS: Eleven patients with PD and bilateral STN DBS implant performed a computerized moral task in ON and OFF stimulation conditions. A control group of PD patients without DBS implant performed the same experimental protocol. All patients underwent motor, cognitive and psychological assessments. RESULTS: STN stimulation was not able to modify neither reaction times nor responses to moral task both when we compared the ON and the OFF state in the same patient (reaction times, p = .416) and when we compared DBS patients with those treated only with the best medical treatment (reaction times: p = .408, responses: p = .776). CONCLUSIONS: Moral judgment is the result of a complex process, requiring cognitive executive functions, problem-solving, anticipations of consequences of an action, conflict processing, emotional evaluation of context and of possible outcomes, and involving different brain areas and neural circuits. Our data show that STN DBS leaves unaffected moral decisions thus implying relevant clinical and ethical implications for DBS consequences on patients' behavior, on decision-making and on judgment ability. In conclusion, the technique can be considered safe on moral behavior

Cathodal transcranial direct current stimulation improves focal hand dystonia in musicians: A two-case study

Focal hand dystonia (FHD) in musicians is a movement disorder causing abnormal movements and irregularities in playing. Since weak electrical currents applied to the brain induce persistent excitability changes in humans, cathodal tDCS was proposed as a possible non-invasive approach for modulating cortical excitability in patients with FHD. However, the optimal targets and modalities have still to be determined. In this pilot study, we delivered cathodal (2 mA), anodal (2 mA) and sham tDCS over the motor areas bilaterally for 20 min daily for five consecutive days in two musicians with FHD. After cathodal tDCS, both patients reported a sensation of general wellness and improved symptoms of FHD. In conclusion, our pilot results suggest that cathodal tDCS delivered bilaterally over motor-premotor (M-PM) cortex for 5 consecutive days may be effective in improving symptoms in FHD

Cuidados paliativos e enfermagem nas dissertações e teses em Portugal: um estudo bibliométrico

OBJETIVO Identificar a produção científica académica sobre cuidados paliativos nos estudos de mestrados e doutoramentos efetuados por enfermeiros em Portugal. MÉTODO Estudo descritivo e retrospetivo, do tipo bibliométrico, recorrendo aos resumos disponíveis nos repositórios das instituições de ensino superior no período 2000-2014. RESULTADOS Dos 1814 trabalhos identificados, 249 corresponderam aos critérios de inclusão (10 teses de doutoramento e 239 dissertações de mestrado). A abordagem metodológica mais representativa é a quantitativa (31,35%), a área mais estudada foi a família/cuidador informal (20,69%) e a população-alvo mais estudada foram os estudantes/profissionais de saúde (38,51%). CONCLUSÃO A produção científica académica nessa área tem vindo a crescer. Embora exista necessidade de investimento contínuo de forma a colmatar as lacunas identificadas.Objective To identify the academic scientific production on palliative care in master dissertations and PhD theses carried out by nurses in Portugal. Method A descriptive retrospective study of bibliometric type with search for the abstracts available in repositories of higher education institutions in the period 2000-2014. Results Of the 1814 papers identified, 249 met the inclusion criteria (ten doctoral theses and 239 master dissertations). The most representative methodological approach was quantitative (31.35%) and the most studied area was family/informal caregiver (20.69%). The most studied target population were the students/health professionals (38.51%). Conclusion The academic scientific production in this area has been growing in spite of the need for continued investment in order to fill the identified gaps.Objetivo Identificar la producción científica académica acerca de los cuidados paliativos en los estudios de maestrías y doctorados llevados a cabo por enfermeros en Portugal. Método Estudio descriptivo y retrospectivo, del tipo bibliométrico, recurriendo a los resúmenes disponibles en los repositorios de las instituciones de enseñanza superior en el período 2000-2014. Resultados De los 1814 trabajos identificados, 249 correspondieron a los criterios de inclusión (10 tesis de doctorado y 239 tesis de maestría). El abordaje metodológico más representativo es el cuantitativo (31,35%), el área más estudiada fue la familia/cuidador informal (20,69%) y la población meta más estudiada fueron los estudiantes/profesionales sanitarios (38,51%). Conclusión La producción científica académica en esa área está creciendo. Aunque exista necesidad de inversión continua de modo a rellenar los espacios identificados

Web-based telemonitoring and delivery of caregiver support for patients with Parkinson disease after deep brain stimulation: protocol

The increasing number of patients, the high costs of management, and the chronic progress of the disease that prevents patients from performing even simple daily activities make Parkinson disease (PD) a complex pathology with a high impact on society. In particular, patients implanted with deep brain stimulation (DBS) electrodes face a highly fragile stabilization period, requiring specific support at home. However, DBS patients are followed usually by untrained personnel (caregivers or family), without specific care pathways and supporting systems