Promoting the psychological well-being of healthcare providers facing the burden of adverse events: a systematic review of second victim support resources

Given the negative impact of adverse events on the wellbeing of healthcare providers, easy access to psychological support is crucial. We aimed to describe the types of support resources available in healthcare organizations, their benefits for second victims, peer supporters' experiences, and implementation challenges. We also explored how these resources incorporate aspects of Safety I and Safety II. We searched six databases up to 19 December 2019 and additional literature, including weekly search alerts until 21 January 2021. Two reviewers independently performed all methodological steps (search, selection, quality assessment, data extraction, formal narrative synthesis). The 16 included studies described 12 second victim support resources, implemented between 2006 and 2017. Preliminary data indicated beneficial effects not only for the affected staff but also for the peer responders who considered their role to be challenging but gratifying. Challenges during program implementation included persistent blame culture, limited awareness of program availability, and lack of financial resources. Common goals of the support programs (e.g., fostering coping strategies, promoting individual resilience) are consistent with Safety II and may promote system resilience. Investing in second victim support structures should be a top priority for healthcare institutions adopting a systemic approach to safety and striving for just culture

SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke

Background and purpose: Acute ischemic stroke (AIS) is a fearful complication of Coronavirus Disease-2019 (COVID-19). Aims of this study were to compare clinical/radiological characteristics, endothelial and coagulation dysfunction between acute ischemic stroke (AIS) patients with and without COVID-19 and to investigate if and how the SARS-CoV-2 spike protein (SP) was implicated in triggering platelet activation. Methods: We enrolled AIS patients with COVID-19 within 12 h from onset and compared them with an age- and sex-matched cohort of AIS controls without COVID-19. Neuroimaging studies were performed within 24 h. Blood samples were collected in a subset of 10 patients. Results: Of 39 AIS patients, 22 had COVID-19 and 17 did not. Admission levels of Factor VIII and von Willebrand factor antigen were significantly higher in COVID-19 patients and positively correlated with the infarct volume. In multivariate linear regression analyses, COVID-19 was an independent predictor of infarct volume (B 20.318, Beta 0.576, 95%CI 6.077-34.559; p = 0.011). SP was found in serum of 2 of the 10 examined COVID-19 patients. Platelets from healthy donors showed a similar degree of procoagulant activation induced by COVID-19 and non-COVID-19 patients' sera. The anti-SP and anti-FcγRIIA blocking antibodies had no effect in modulating platelet activity in both groups. Conclusions: SARS-CoV-2 infection seems to play a major role in endothelium activation and infarct volume extension during AIS

Cavoli a merenda: Studio di un progetto per la prevenzione dell\u2019obesit\ue0 infantile a scuola

L\u2019obesit\ue0 infantile costituisce una seria minaccia per la salute della popolazione mondiale [1]. Un terzo dei bambini italiani \ue8 sovrappeso o obeso [2], una condizione che crea stigmatizzazione, depressione, disagio sociale e aumento del rischio di patologie metaboliche e cardiovascolari sia in et\ue0 infantile che in et\ue0 adulta [3]. Secondo l\u2019Organizzazione Mondiale della Sanit\ue0, per porre fine a questa epidemia \ue8 necessario un approccio multidisciplinare che coinvolga istituzioni, scuola e famiglie [4]. Una strategia complessa che in Italia \ue8 stata implementata solo in parte, lasciando a singole scuole, associazioni e aziende sanitarie la responsabilit\ue0 di mettere in atto iniziative pratiche. In questo scenario si colloca \u201cMerenda sana e movimento: un\u2019associazione vincente\u2019 \u2019 dell\u2019ASS6 del Friuli Occidentale, uno dei progetti attivi da pi\uf9 tempo sul territorio nazionale. L\u2019iniziativa, tramite un intervento su un pasto chiave, quello della merenda a scuola, e sull\u2019attivit\ue0 fisica, mira a migliorare abitudini e stile di vita dei bambini e delle loro famiglie. Lo scopo della presente tesi \ue8 valutare l\u2019efficacia del progetto e del suo approccio comunicativo..

Los que son y no son: percorsi di identità (so)nate nella Cuba della seconda metà del XIX secolo e inizi del XX

The son is configured into the orbit of Cuban popular music as the mulatto music genre par excellence,  thanks to the amalgam of musical elements and structural features of Spanish and African origins. In its heyday - when are defined new modes of interpretation and new sonic possibilities - shares political and cultural unrest of vanguards that, through the recognition of the African component, try to build a coherent concept of nation, highlighting the contribution of black people to cultural and political processes. This work is based on the hypotheses suggested in some cuban studies recently published, about the causal relationship between the son’s development and the shape of national identity in the period of the Wars of Independence, to come to find through the  thematic analysis of representative texts the genre's functioning within this perspective

Comparing swab- and different symptoms-based strategies to ascertain COVID-19 recovery in healthcare workers: a cost-effectiveness analysis

Objective Given the human and economic cost of the COVID-19 pandemic, protecting healthcare workers (HCW) and ensuring continuity of care is critical. The aim of this study is to evaluate the cost-effectiveness of different strategies to ascertain COVID-19 recovery in HCWs. Methods Data were collected from the hospital health surveillance program on HCWs at the University Hospital of Verona between 29/02/2020 and 14/04/2021. The diagnosis of SARS-CoV-2 infection and the assessment of the recovery were made through RT-PCR on oro-nasopharyngeal swab-sample. Recovery time and probability were estimated through Kaplan-Meier estimate. For each recovery assessment strategy costs (laboratory diagnostics and human resources), expressed in local currency (euro-euro), and working days saved (WDS-effectiveness) were estimated. A decision-tree was created where each knot was a time point scheduled by the different recovery assessment strategies. A Monte Carlo simulation method was used, and probabilistic sensitivity analysis assessed the effect of input uncertainty. Results In the study period 916 (9.9%) HCWs tested positive. Recovery time through symptom-based strategy (21 days 0.95 CI 16-24) was significantly lower compared to swab-based one (25 days 0.95 CI 23-28, p < 0.001). The swab-based strategy was dominated by all symptoms-based ones. Symptoms-based with a swab on days 14 and 17 had an ICER of 2 euro/WDS and 27 euro/WDS compared to the one scheduled on days 10 and 17 and with only one swab on the 17th day. Conclusions Scheduling swabs on days 14 and 17 in a symptom-based strategy was the most cost-effective, saving 7.5 more working days than the standard one with swabs on days 10 and 17

Genetic Control of Immune Response in Carriers of the 8.1 Ancestral Haplotype: Correlation with Levels of IgG Subclasses: Its Relevance in the Pathogenesis of Autoimmune Diseases

Ancestral haplotype (AH) 8.1(HLA-A1, Cw7, B8, TNFAB*a2b3, TNFN*S, C2*C, Bf*s, C4A*Q0, C4B*1, DRB1*0301, DRB3*0101, DQA1*0501, DQB1*0201) seems to be associated with susceptibility to autoimmune diseases. Different mechanisms are probably involved in increasing autoimmunity, such as unbalanced cytokine production and the lack of C4A protein. So AH 8.1 modifies immune response in many ways. In this study we demonstrate that IgG2 serum levels were significantly lower in 8.1 AH carriers than in 8.1 AH non-carriers. On the contrary, as regards IgG1, IgG3, IgG4 serum levels, no significant differences were observed between the two groups. In AH 8.1 carriers low IgG2 levels might take to slower clearance of the infectious agent and hence to a lasting presence of it. The persistence of infectious antigens could determine an increased production of autoantibodies with a higher risk of cross-reactions

How to evaluate a schedule for SARS-CoV-2 swab test timing: a mixed model approach to study how probability of SARS-CoV-2 positivity changes over time.

BACKGROUND During the COVID-19 pandemic, swab tests proved to be effective in containing the infection and served as a means for early diagnosis and contact tracing. However, little evidence exists regarding the correct timing for the execution of the swab test, especially for asymptomatic individuals and health care workers. OBJECTIVE The objective of this study was to analyze changes in the positive findings over time in individual SARS-CoV-2 swab tests during a health surveillance program. METHODS The study was conducted with 2071 health care workers at the University Hospital of Verona, with a known date of close contact with a patient with COVID-19, between February 29 and April 17, 2020. The health care workers underwent a health surveillance program with repeated swab tests to track their virological status. A generalized additive mixed model was used to investigate how the probability of a positive test result changes over time since the last known date of close contact, in an overall sample of individuals who tested positive for COVID-19 and in a subset of individuals with an initial negative swab test finding before being proven positive, to assess different surveillance time intervals. RESULTS Among the 2071 health care workers in this study, 191 (9.2%) tested positive for COVID-19, and 103 (54%) were asymptomatic with no differences based on sex or age. Among 49 (25.7%) cases, the initial swab test yielded negative findings after close contact with a patient with COVID-19. Sex, age, symptoms, and the time of sampling were not different between individuals with an initial negative swab test finding and those who initially tested positive after close contact. In the overall sample, the estimated probability of testing positive was 0.74 on day 1 after close contact, which increased to 0.77 between days 5 and 8. In the 3 different scenarios for scheduled repeated testing intervals (3, 5, and 7 days) in the subgroup of individuals with an initially negative swab test finding, the probability peaked on the sixth, ninth and tenth, and 13th and 14th days, respectively. CONCLUSIONS Swab tests can initially yield false-negative outcomes. The probability of testing positive increases from day 1, peaking between days 5 and 8 after close contact with a patient with COVID-19. Early testing, especially in this final time window, is recommended together with a health surveillance program scheduled in close intervals

The Effect of Test Timing on the Probability of Positive SARS-CoV-2 Swab Test Results: Mixed Model Approach

During the COVID-19 pandemic, swab tests proved to be effective in containing the infection and served as a means for early diagnosis and contact tracing. However, little evidence exists regarding the correct timing for the execution of the swab test, especially for asymptomatic individuals and health care workers

Light-driven water oxidation with a molecular tetra-cobalt(iii) cubane cluster

Photoinduced water oxidation to molecular oxygen takes place in systems made of [Ru(bpy)3]2+ (bpy = 2,2'-bipyridine) as the photosensitizer, [Co4O4(O2CMe)4(py)4] (py = pyridine) as the molecular catalyst and Na2S2O8 as the sacrificial electron acceptor. The photochemical quantum yield of the process reaches the outstanding value of 30% and depends on pH and catalyst concentration. Transient absorption spectroscopy experiments aimed to clarify the first events of the photocatalytic process are also reported