An Embankment on Soft Clays with Sand Drains Numerical Characterization of the Parameters from In-situ Measurements

The deformation parameters of a soft lacustrine deposit, with vertical sand drains, are evaluated by means of field measurements obtained during and after the construction of a railway embankment. The geotechnical system, modelled as linearly elastic and in plane strain, is analyzed by means of the finite element method and the estimation problem is solved adopting a Bayesian approach. The experimental data, the a priori estimation of the parameters and their uncertainties are considered in the back-analysis. The results provide the optimal values of the parameters, a measure of their uncertainties and, consequently, an index of the effectiveness of the field measurement program

Prospective Minority Students\u27 Perceptions of Application Packets for Professional Psychology Programs: A Qualitative Study

This article reports the results of a qualitative study designed to determine issues salient in Black and Hispanic American students\u27 review and evaluation of program-application packets in professional psychology. The study served as an extension to the Yoshida et al. (1989) quantitative investigation. Students interested in pursuing doctoral studies in counseling or school psychology (N = 22) served as the sample. The qualitative methodology incorporated a think-aloud procedure and semistructured interviews. A theme analysis of transcribed interviews identified both major and minor themes central to participants\u27 evaluation of the packets. Major themes included financial aid, program requirements and course descriptions, demography of the student body, and the quality and clarity of application material. Specific suggestions on developing an application packet to send to inquiring prospective students are put forth. It is recommended that such a packet could serve as a cost-effective minority-recruitment strategy

Minority Student Perceptions of Professional Pscyhology Application Packets: A Qualitative Study

This article reports the results of a qualitative study designed to determine issues salient in Black and Hispanic American students\u27 review and evaluation of program-application packets in professional psychology. The study served as an extension to the Yoshida et al. (1989) quantitative investigation. Students interested in pursuing doctoral studies in counseling or school psychology (N = 22) served as the sample. The qualitative methodology incorporated a think-aloud procedure and semistructured interviews. A theme analysis of transcribed interviews identified both major and minor themes central to participants\u27 evaluation of the packets. Major themes included financial aid, program requirements and course descriptions, demography of the student body, and the quality and clarity of application material. Specific suggestions on developing an application packet to send to inquiring prospective students are put forth. It is recommended that such a packet could serve as a costeffective minority-recruitment strategy

Daughters\u27 Perspectives on Maternal Substance Abuse: Pledge to Be a Different Kind of Mother

The purpose of this grounded theory (Strauss & Corbin, 1998) study was to explore the experiences of racially and culturally diverse young mothers whose own mothers abused substances two decades ago when substance abuse peaked in inner city, urban neighborhoods in the United States and to identify the factors that have influenced how they parent their own children today. Semi-structured interviews were conducted with ten drug-free mothers who report having been raised by a mother who was addicted to drugs, primarily crack cocaine during their childhoods. The emergent grounded theory is that exposure to maternal substance abuse has a significant and unique impact on female children throughout their lifespan, with particular emphasis at the onset of motherhood. Among the goals the young mothers expressed is that they wanted to be there for their children, protect their daughters from sexual abuse, and raise sons who do not abuse women

Effect of n-acetylcysteine administration on 30-day mortality in critically ill patients with septic shock caused by carbapenem-resistant klebsiella pneumoniae and acinetobacter baumannii. A retrospective case-control study

Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) and Acinetobacter baumannii (CR-Ab) represent important cause of severe infections in intensive care unit (ICU) patients. N-Acetylcysteine (NAC) is a mucolytic agent with antioxidant and anti-inflammatory properties, showing also in-vitro antibacterial activity. Aim was to evaluate the effect on 30-day mortality of the addition of intravenous NAC to antibiotics in ICU patients with CR-Kp or CR-Ab septic shock. A retrospective, observational case:control study (1:2) in patients with septic shock caused by CR-Kp or CR-Ab hospitalized in two different ICUs was conducted. Cases included patients receiving NAC plus antimicrobials, controls included patients not receiving NAC. Cases and controls were matched for age, SAPS II, causative agent and source of infection. No differences in age, sex, SAPS II score or time to initiate definitive therapy were observed between cases and controls. Pneumonia and bacteremia were the leading infections. Overall, mortality was 48.9% (33.3% vs. 56.7% in cases and controls, p = 0.05). Independent risk factors for mortality were not receiving NAC (p = 0.002) and CR-Ab (p = 0.034) whereas therapy with two in-vitro active antibiotics (p = 0.014) and time to initial definite therapy (p = 0.026) were protective. NAC plus antibiotics might reduce the 30-day mortality rate in ICU patients with CR-Kp and CR-Ab septic shock

Clinical course of Coronavirus Disease-19 in patients with haematological malignancies is characterized by a longer time to respiratory deterioration compared to non-haematological ones: results from a case-control study

Background We evaluated clinical features and risk factors for mortality in patients with haematological malignancies and COVID-19. Methods Retrospective, case-control (1:3) study in hospitalized patients with COVID-19. Cases were patients with haematological malignancies and COVID-19, controls had COVID-19 without haematological malignancies. Patients were matched for sex, age and time of hospitalization. Results Overall, 66 cases and 198 controls were included in the study. Cases had higher prior corticosteroid use, infection rates, thrombocytopenia and neutropenia and more likely received corticosteroids and antibiotics than controls. Cases had higher respiratory deterioration than controls (78.7% vs 65.5%, p = 0.04). Notably, 29% of cases developed respiratory worsening > 10 days after hospital admission, compared to only 5% in controls. Intensive Care Unit admission and mortality were higher in cases than in controls (27% vs 8%, p = 0.002, and 35% vs 10%, p < 0.001). At multivariable analysis, having haematological malignancy [OR4.76, p < 0.001], chronic corticosteroid therapy [OR3.65, p = 0.004], prior infections [OR57.7, p = 0.006], thrombocytopenia [OR3.03, p < 0.001] and neutropenia [OR31.1, p = 0.001], low albumin levels [OR3.1, p = 0.001] and >= 10 days from hospital admission to respiratory worsening [OR3.3, p = 0.002] were independently associated with mortality. In cases, neutropenia [OR3.1, p < 0.001], prior infections [OR7.7, p < 0.001], >= 10 days to respiratory worsening [OR4.1, p < 0.001], multiple myeloma [OR1.5, p = 0.044], the variation of the CT lung score during hospitalization [OR2.6, p = 0.006] and active treatment [OR 4.4, p < 0.001] all were associated with a worse outcome. Conclusion An underlying haematological malignancy was associated with a worse clinical outcome in COVID-19 patients. A prolonged clinical monitoring is needed, since respiratory worsening may occur later during hospitalization

Co-infection of SARS-CoV-2 with Chlamydia or Mycoplasma pneumoniae: a case series and review of the literature

Introduction: The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only two cases of Chlamydia pneumoniae have been reported in a large US study so far. Methods: In the present report, we describe a series of seven patients where co-infection with C. pneumoniae (n = 5) or M. pneumoniae (n = 2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. Results and conclusion: An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed

Anticholinergic drug burden tools/scales and adverse outcomes in different clinical settings: a systematic review of reviews

Background: Cumulative anticholinergic exposure (anticholinergic burden) has been linked to a number of adverse outcomes. To conduct research in this area, an agreed approach to describing anticholinergic burden is needed. Objective: This review set out to identify anticholinergic burden scales, to describe their rationale, the settings in which they have been used and the outcomes associated with them. Methods: A search was performed using the Healthcare Databases Advanced Search of MEDLINE, EMBASE, Cochrane, CINAHL and PsycINFO from inception to October 2016 to identify systematic reviews describing anticholinergic burden scales or tools. Abstracts and titles were reviewed to determine eligibility for review with eligible articles read in full. The final selection of reviews was critically appraised using the ROBIS tool and pre-defined data were extracted; the primary data of interest were the anticholinergic burden scales or tools used. Results: Five reviews were identified for analysis containing a total of 62 original articles. Eighteen anticholinergic burden scales or tools were identified with variation in their derivation, content and how they quantified the anticholinergic activity of medications. The Drug Burden Index was the most commonly used scale or tool in community and database studies, while the Anticholinergic Risk Scale was used more frequently in care homes and hospital settings. The association between anticholinergic burden and clinical outcomes varied by index and study. Falls and hospitalisation were consistently found to be associated with anticholinergic burden. Mortality, delirium, physical function and cognition were not consistently associated. Conclusions: Anticholinergic burden scales vary in their rationale, use and association with outcomes. This review showed that the concept of anticholinergic burden has been variably defined and inconsistently described using a number of indices with different content and scoring. The association between adverse outcomes and anticholinergic burden varies between scores and has not been conclusively established