5,249 research outputs found

    La comunicazione della patologia fetale. Il punto di vista della donna, del medico e dell’équipe

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    La comunicazione della patologia fetale riveste una serie di significati con implicazioni psicologiche e sociali importanti che richiedono al medico capacità comunicativa, attitudine alla comprensione della paziente e delle dinamiche istituzionali. La donna: la patologia ostetrica è una crisi dentro la crisi. Nella patologia ostetrica le aspettative di vivere la nuova condizione di madre e di sentirsi più compiutamente famiglia vengono frustrate e tradite. In seguito alla diagnosi di patologia, alla perdita del bambino immaginario può seguire la perdita del bambino reale. Nel caso in cui la coppia decida di proseguire la gravidanza, il sentimento di lutto può prolungarsi per tutta la vita. Il medico: dal momento della prima diagnosi per la donna inizia l’elaborazione del lutto. Anche il medico che comunica la diagnosi vive questo momento con disagio. Inoltre, il medico sente il disagio dell’incertezza: l’incertezza può essere accolta e ascoltata. Raramente in questa situazione è possibile comunicare in modo efficace le informazioni necessarie. È importante comunicare gradualmente e dedicare un secondo incontro alle richieste di spiegazioni. L’équipe: è importante che gli operatori possano condividere questa esperienza all’interno dell’equipe. L’equipe che si occupa di diagnosi prenatale dovrebbe essere composta da persone che hanno scelto liberamente di occuparsi di questo aspetto della medicina. L’equipe diviene un contenitore per le emozioni estreme delle pazienti e degli operatori

    4-Quinolone fused heterocyclic ring systems by intramolecular reactions of 4-quinolone-2-carboxamides

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    A versatile synthetic route to new 4-quinolone-based polycyclic systems is described. TFA-catalyzed intramolecular reaction of N-unsubstituted quinolone-2-carboxylic acid amides gives structurally diverse compounds, depending on the length of the chain. Acid treatment of \u3b2-oxoamides furnishes 3H-pyrazino[1,2-a]quinoline-4,6-diones, due to the nucleophilic attack of N-1 to the carbonyl group, whereas TFA treatment of \u3b4- and \u3b5-oxoamides leads to the formation of tetracyclic compounds by a tandem heteroannulation reaction

    Predicting success of range-expanding coral reef fish in temperate habitats using temperature-abundance relationships

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    © 2018 Booth, Beretta, Brown and Figueira. An 18-year database of coral reef fish expatriation poleward in South East Australia was used to estimate persistence of coal reef fish recruits on temperate reefs. Surveys have identified over 150 coral reef fish species recruiting to temperate reefs at latitudes of 34°S (Sydney) and 60 species to 37°S (Merimbula) with 20 and 5 species respectively overwintering in at least 1 year over the study duration. We developed indices of vulnerability of key species to drops in water temperatures, by relating drops in abundances of species to temperature drops. Twenty species were ranked according to their temperature vulnerability. Overall, the families Chaetodontidae (butterflyfishes), Acanthuridae (surgeonfishes), Labridae (wrasses) and Pomacetnridae (damselfishes) had similar cold-water tolerance. However, there was considerable variability within families, for instance in the Pomacentridae, species from the genus Abudefduf appeared to have better cold-temperature tolerance than the other species. Predicted minimum overwintering temperature varied from 15.6°C to 19.8°C, with some species showing lower Tzero at Merimbula, the more poleward location. There was general concordance between a species' tolerance to cold-water and its tendency to occur as an overwinter but also notable exceptions. So while this work demonstrates the potential utility of tolerance to seasonal temperature drops as a means to predict range expansion capacity of vagrant species, the exceptional cases serve to highlight alternative factors. Specifically, tolerance to seasonal cooling of water is not the only important factor when predicting the range expansion capacity of a species. Factors affecting the general abundance of the vagrants, such as habitat suitability and competitor/predator environments will also be critical where overwinter survival becomes a lottery

    SAFETY AND HEALTH SITE INSPECTIONS FOR ON-FIELD RISK ANALYSIS AND TRAINING

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    The field of construction is always affected by a large number of accidents at work that have many different causes and responsible. Therefore, it is of utmost importance to focus on all these issues, in order to reduce all risk factors that can undermine individuals’ safety on building sites. The objective of the research is then the development of a method for quick on site analysis of all critical issues that can create accidents and identification of the related causes in order to directly provide a correct and focused training identified as the best method to act on the causes to reduce accidents. The research was carried on during construction of the Universal Exhibition of Milan – Expo 2015 – that counted almost 70 contemporary construction sites. To reach the goals further research steps has been followed and in particular: (i) inspections on building sites through all the Expo area; (ii) analysis of the main identified problems; (iii) development of a methodology to quickly identify the cause of problems; (iv) validation of the method through back office analysis of site documents; (v) correct on-site training according to found problem. During the whole construction site, the improvements in criticalities solving have been visible thanks to the focused training. The developed method, carried on in a high-risk environment, is applicable in any other building sites and environment as independent from the boundary conditions of the place
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