Determinants of aggression against all health care workers in a large-sized university hospital

Background: The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events. Methods: A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: Worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors). Results: Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening. Conclusions: The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level

Patterns of amenable child mortality over time in 34 member countries of the Organisation for Economic Co-operation and Development (OECD): Evidence from a 15-year time trend analysis (2001-2015)

Objectives To analyse the trends of amenable mortality rates (AMRs) in children over the period 2001-2015. Design Time trend analysis. Setting Thirty-four member countries of the Organisation for Economic Co-operation and Development (OECD). Participants Midyear estimates of the resident population aged 6414 years. Primary and secondary outcome measures Using data from the WHO Mortality Database and Nolte and McKee's list, AMRs were calculated as the annual number of deaths over the population/100 000 inhabitants. The rates were stratified by age groups (&lt;1, 1-4, 5-9 and 10-14 years). All data were summarised by presenting the average rates for the years 2001/2005, 2006/2010 and 2011/2015. Results There was a significant decline in children's AMRs in the &lt;1 year group in all 34 OECD countries from 2001/2005 to 2006/2010 (332.78 to 295.17/100 000; %\u394-11.30%; 95% CI -18.75% to -3.85%) and from 2006/2010 to 2011/2015 (295.17 to 240.22/100 000; %\u394-18.62%; 95% CI -26.53% to -10.70%) and a slow decline in the other age classes. The only cause of death that was significantly reduced was conditions originating in the early neonatal period for the &lt;1 year group. The age-specific distribution of causes of death did not vary significantly over the study period. Conclusions The low decline in amenable mortality rates for children aged 651 year, the large variation in amenable mortality rates across countries and the insufficient success in reducing mortality from all causes suggest that the heath system should increase its efforts to enhance child survival. Promoting models of comanagement between primary care and subspecialty services, encouraging high-quality healthcare and knowledge, financing universal access to healthcare and adopting best practice guidelines might help reduce amenable child mortality

Longitudinal evolution of the immune suppressive glioma microenvironment in different synchronous lesions during treatment

The role of immune suppression in glioma progression has been clearly established.1 We and others have recently demonstrated that myeloid cells play a major role in the tumor microenvironment of glioblastoma (GBM) patients,2,3 and that not only bone marrow-derived macrophages (BMDMs) have a higher intrinsic immune suppressive ability compared to resident microglial cells (MG), but also that this ability greatly increases going from the periphery to the tumor core.3 In lower grade gliomas (grades II and III), a much lower amount of BMDM is present, devoid of immune suppressive ability.3 We present here a longitudinal analysis of the immune infiltrate in a patient with a synchronous occurrence of GBM in the left temporal lobe, and a low-grade glioma (LGG) in the right frontal lobe, with discordant isocitrate dehydrogenase (IDH)-mutational status,4 followed by two GBM relapse

Il V e il IV secolo, in LE NECROPOLI DI PONTECAGNANO:STUDI RECENTI

L’articolo raccoglie una serie di interventi sulla documentazione funeraria di Pontecagnano elaborati in occasione del PRIN: Etruschi in aree di confine e rapporti con i Greci. Il rituale funerario e l’ideologia della morte tra VI e V se. a.C. L’attenzione è incentrata sulla necropoli del Picentino, ad ovest dell’abitato, di cui sono editi da tempo sistematicamente i sepolcreti della Prima Età del Ferro e di alcuni settori impiantati ex-novo alla metà del IV sec. a.C.; la necropoli inoltre è stata oggetto di un progetto di informatizzazione mediante la redazione di un GIS. Lo studio delle sepolture databili tra il VI e la metà del IV sec. a.C. consente di colmare un vuoto della documentazione. Nella sezione curata da A.Serritella si approfondisce lo sviluppo topografico e le dinamiche di trasformazione tra il terzo quarto del V e i primi decenni del IV sec. a.C

Past intensification trajectories of livestock led to mixed social and environmental services

International audienceRecent studies highlighted the multiple positive and negative contributions of livestock to society. Livestock production, through its direct and indirect impacts on land use, is an important driver of services provision. Although a few studies provide an account on the multiple services in different livestock systems, there is still an important knowledge gap on the drivers that contribute to the differentiation of services provisioning across areas. We investigated the hypothesis that the current level of services has derived from the past intensification trajectories of livestock. The objective of this study was to understand the influences of past changes in livestock, land-use and socio-economic variables on the current provision of social, environmental and cultural services by the livestock sector in France. We combined a long-term country-wide database on livestock intensification between 1938 and 2010 and a database on services provisioning in 2010. We used a set of multivariate methods to simultaneously analyse the changes in livestock intensification from 1938 to 2010 and the current level of services provisioning. Our analysis focused on a set of 60 French departments where livestock play a significant economic role in agricultural production. Our study revealed that the provision of services was spatially structured and based on three groups of departments, characterised by different rates of change in intensification variables. In the first group, 'Intensive livestock areas', the high level of employment in the livestock sector was mainly associated with high rates of change in monogastric stocking rates (+1045%) and milk productivity (+451%). In the second group, 'Extensive livestock areas', the high levels of environmental and cultural services were mainly associated with moderate rates of change in herbivores stocking rate (+95%) and the stability of grassland area (+13%). In the third group, 'Transition areas', the low provision of all services was associated with the decline in livestock due to crop expansion. This study provides knowledge to understand how past changes determined the current contribution of livestock areas in providing differentiated bundles of services, which might help steer the development of the current livestock sector towards more sustainable trajectories