Symptom-Level Description of Nursing Perceptions About Unwarranted Clinical Variation, Inequality in Access to Cancer Services, Specific-Symptom Knowledge: An Italian Web-Based Survey

Objectives: This study aimed to describe the cancer nurses’ views regarding the relevance of cancer symptom-specific knowledge, unwarranted clinical variation, and inequities in access to cancer services. Describing how nurses perceive these aspects could help identify research priorities and a practical framework to prioritize clinical practice guidelines. Data Sources: A web-based survey was performed using a convenience sample of 810 nurses employed in cancer settings and cross-sectional data collection. The survey adopted a previously validated questionnaire investigating 14 symptoms. Conclusion: This study revealed which cancer symptoms require priority attention to define evidence-grounded guidance for decreasing unwarranted clinical variation and inequities in access to cancer services. Future multiprofessional and multinational studies are recommended to provide an in-depth description of the investigated phenomena. Implications for Nursing Practice: Participants reported higher mean scores in pain-specific knowledge than other symptoms. Social functioning alterations and psychological disorders seem to be highly susceptible to unwarranted clinical variation and inequities in access to cancer services. This information could drive tailored interventions to improve nursing practice

Economia internazionale. Globalizzazione, produzione e occupazione

Il processo di globalizzazione dell’economia, ispirato ai principi della deregolamentazione e della flessibilità, ha costituito il carattere predominante del sistema delle relazioni economiche internazionali nella nostra epoca. Il presente testo nasce dall’idea di offrire uno strumento utile per la comprensione delle cause, dei meccanismi in azione e delle possibili conseguenze dei processi di liberalizzazione e di globalizzazione dei mercati. Benché la finalità del volume sia prevalentemente didattica, l’obiettivo è anche quello di fornire una prospettiva di lettura e di interpretazione degli epifenomeni della globalizzazione sufficientemente aperta anche ad una visione critica dei processi, degli assetti istituzionali e delle opzioni di politica economica e commerciale. Ciò soprattutto alla luce della evidente situazione di debolezza nella quale sembra versare oggi il modello di globalizzazione liberista, deregolata e senza governance che ha caratterizzato il sistema delle relazioni internazionali negli ultimi decenni

Acoustic forcing on swirling flow: experiments and simulation

We investigated the effect of sound irradiated from loudspeakers on the flow of preheated air in the combustion chamber of a swirl burner. The temporally periodic pattern of the flow generated by the sound was detected by fast particle image velocimetry (PIV), with a repetition rate that was adapted to the observation of 12 phase angles of the irradiated monochromatic sound. The strong observed movement of the air is related to the movement by the sound itself, as determined by the pressure measurements with microphones. The PIV measurements reveal also a nonlinear interaction between the irradiated sound and the precession of the vortex core. The accuracy of the sound measurements was tested by determining in quiescent air the acoustic velocity by microphones and as well by PIV; good agreement was obtained thereby. Numerical calculations, using large eddy simulation and accounting for the sound forcing by variation in the mass flow at the inlet of the computational domain, approximately reproduce some of the experimental results

Crafting strategic thinking: Creative pedagogy for management studies

This paper presents a format from the creative arts, refocused for application in management studies, as a method to enhance and support the development of strategic thinking. It involves the application of multi-page paper constructions (zines) within facilitated sessions to enhance imaginative strategic thinking by both management learners and practitioners. It draws on a longitudinal case study of the six-phase evolution of affordances of a zine as a method for reflective, creative and connected thinking. The focus moves from purely personal private reflections to the possibility of deploying zines for collective reflection and action. Specific examples are provided of zine workshops and events. Strategic thinking relates to volatility, uncertainty, complexity and ambiguity (VUCA). The affordances of zines relating to tangibility, efficiency and mental processes appear well-suited to a VUCA context. The paper concludes with reflections on the nature of multi-disciplinary and trans-disciplinary collaborations such as this one

CSF/serum matrix metallopeptidase-9 ratio discriminates neuro Behcet from multiple sclerosis

In neuro Behcet disease with multiple sclerosis-like features, diagnosis could be challenging. Here, we studied the cerebrospinal fluid and serum inflammatory profile of 11 neuro Behcet and 21 relapsing-remitting multiple sclerosis patients. Between the soluble factors analyzed (MMP9, TNF, IL6, CXCL13, CXCL10, CXCL8, IFN, IL10, IL17, IL23, and others) we found MMP9 increased in neuro Behcet serum compared to multiple sclerosis and decreased in cerebrospinal fluid. Furthermore, neuro Behcet analysis of circulating natural killer CD56(DIM) subset suggests their potential involvement in increased MMP9 production. We believe that these findings may have a translational utility in clinical practice

Metabolic Variability of a Multispecies Probiotic Preparation Impacts on the Anti-inflammatory Activity

Background: In addition to strain taxonomy, the ability of probiotics to confer beneficial effects on the host rely on a number of additional factors including epigenetic modulation of bacterial genes leading to metabolic variability and might impact on probiotic functionality. Aims: To investigate metabolism and functionality of two different batches of a probiotic blend commercialized under the same name in Europe in models of intestinal inflammation. Methods: Boxes of VSL#3, a probiotic mixture used in the treatment of pouchitis, were obtained from pharmacies in UK subjected to metabolomic analysis and their functionality tested in mice rendered colitis by treatment with DSS or TNBS. Results: VSL#3-A (lot DM538), but not VSL#3-B (lot 507132), attenuated "clinical" signs of colitis in the DSS and TNBS models. In both models, VSL#3-A, but not VSL#3-B, reduced macroscopic scores, intestinal permeability, and expression of TNFα, IL-1β, and IL-6 mRNAs, while increased the expression of TGFβ and IL-10, occludin, and zonula occludens-1 (ZO-1) mRNAs and shifted colonic macrophages from a M1 to M2 phenotype (P < 0.05 vs. TNBS). In contrast, VSL#3-B failed to reduce inflammation, and worsened intestinal permeability in the DSS model (P < 0.001 vs. VSL#3-A). A metabolomic analysis of the two formulations allowed the identification of two specific patterns, with at least three-folds enrichment in the concentrations of four metabolites, including 1-3 dihydroxyacetone (DHA), an intermediate in the fructose metabolism, in VSL#3-B supernatants. Feeding mice with DHA, increased intestinal permeability. Conclusions: Two batches of a commercially available probiotic show divergent metabolic activities. DHA, a product of probiotic metabolism, increases intestinal permeability, highlighting the complex interactions between food, microbiota, probiotics, and intestinal inflammation