Ambulatorio a gestione infermieristica per la rimozione del tappo di cerume

Il progetto per l'apertura di un ambulatorio infermieristico per la rimozione del tappo di cerume nell'Azienda USL di Rimini nasce nel 2007 e si è implementato nel tempo dando la possibilití  a infermieri esperti di agire le conoscenze acquisite. Obiettivo: dimostrare, tramite i dati di attivití , che l'ambulatorio a gestione infermieristica è in grado di dare una risposta tempestiva e appropriata all'utenza. Materiali e metodi: i dati di attivití  sono stati analizzati con statistiche descrittive e raccolti attraverso un' analisi retrospettiva. Risultati: l'implementazione dell'ambulatorio infermieristico ha portato nel 2010 ad un incremento delle prestazioni rispetto al 2009 che risultano pari a 682 ; i dati di attivití  del 2011 e 2012 mostrano un andamento più costante e un consolidamento di giornate di apertura e del numero di prestazioni svolte per seduta; tutte le problematiche di pertinenza specialistica sono state correttamente riconosciute dall'infermiere. Conclusioni: la gratificazione professionale dimostrata degli operatori, il buon funzionamento del servizio, il mantenimento degli standard qualitativi e la richiesta minima di risorse economiche per la realizzazione del progetto indicano che, l'ambulatorio a gestione infermieristica per la rimozione del tappo di cerume, potrebbe essere replicato anche in altre realtí  sanitarie. L'ipotesi di lavoro futura è rivolta alla realizzazione di un opuscolo informativo/formativo per gli utenti che soffrono di questo disturbo, un analisi del grado di soddisfazione dell'utenza e una nuova modalití  di refertazione infermieristica.Parole Chiave: tappo di cerume, competenze cliniche, ruolo infermieristicoWalk-in nursing clinic for earwax removalIn the USL Rimini was set up in 2007 a nursing service for the cerumen removal and it was implemented during time.To demonstrate through recorded activities data that this service managed by nurses is able to provide a timely and appropriate response to the users.  Activities data were analyzed using descriptive statistics.The implementation of the nursing service in 2010 led to an increase (= 682) in performance compared to 2009, activities data of 2011 and 2012 show a more consistent pattern and consolidation of open days and in the number of services performed per session, all issues reported by users have been properly recognized by specialist nurse. All positive insights in terms of improved job satisfaction, high quality standards, minimum requirement of financial resources indicate that this service, may be replicated in other health care facilities. Future developments of the service should be aimed at the development of  an informative brochure for users, an evaluation of users' satisfaction and an improvement of nursing notes

Spectroscopic evidence of in-gap states at the SrTiO3/LaAlO3 ultrathin interfaces

Experimental evidence of differences in the electronic properties of an insulating and a conducting SrTiO3/LaAlO3 interface is provided by soft x-ray spectroscopies. While core level photoemission measurements show that only at the conducting interface Ti ions with 3+ ionization state are present, by using resonant photoemission and x-ray absorption spectroscopies, it is shown that in both samples in-gap states with a Ti 3d character are present, but their density is higher at the conducting interface

Colloquial Arabic Teaching at Ca' Foscari

Since the '70s Ca' Foscari teachers have been facing the challenge of diglossia that typifies the Arab world where the oral use of Standard Arabic is reserved to specific situations, while colloquial varieties of the same language are used for ordinary conversations. Thus, learning Colloquial Arabic is a paramount need to communicate with native Arabic speakers. Moreover, diglottic proficiency is necessary to access several contemporary cultural outputs of the Arab world. This article describes the features of Arabic diglossia and instructional approaches meant to cope with the phenomenon. It then offers a brief account of Colloquial Arabic teaching at Ca' Foscari, which has been a European vanguard in the field

Monetary and Fiscal Policy Interaction in the Euro Area with Different Assumptions on the Phillips Curve

In this paper we carry over a static version of a New Keynesian Macro Model to a monetary union. For a similar approach see Uhlig (2002). We will show in particular that a harmonious functioning of a monetary union critically depends on the correlation structure of shocks that hit the currency area. Additionally a high degree of integration in product markets is advantageous for the ECB as it prevents that national real interest rates can drive a wedge between macroeconomic outcomes across member states. In particular small countries are in a vulnerable and therefore in need for fiscal policy as an independent stabilization agent with room to breath

Giustizia e letteratura II

The book explores and links different cultures, disciplines and perspectives, with a far more original and broad approach to the relations between “Justice” and “Literature” than more traditional works focused on “Law” and “Literature”. The many contributions from writers, literature and movie critics, psychologists, and criminal law practitioners and scholars, draw a complex and interdisciplinary path through primary texts of Italian and international literature, with the aim of prompting readers’ reflections about core issues related to law, crime, and responsibility. Through the analysis of masterpieces of literature, theatre and cinema, this book aims at stimulating dialogue and debate, as well as critical abilities and a deep-rooted sense of justice, amongst both law professionals and citizens at large. Literature and other forms of narration are presented here as a privileged key to approach long-standing questions about (amongst other) causes and consequences of crime; victimization and coping mechanisms; the role of criminal law and criminal proceedings; legalism and equity; law and ethics; the ‘time’ of justice; freedom, responsibility, culpability and forgiveness; rules, legality, socialization and culture; language and images as mediums for justice issues; the impact of prejudice and of existing balances of power on the application of the law; social and legal mechanisms of exclusion and inclusion; gender issues and legal systems; and so on. A whole section (Part V) is devoted to crimes against humanity and how the literary testimony may be understood both as a strategy to resist injustice and to seek justice, and as a way to prevent further horrors. Through this quest for justice in literature and arts, the volume proposes a wider cultural and research project which defies traditional formalistic and retributive approaches to criminal law, in order to open new perspectives for restorative and reintegrative strategies

Do countries belonging to the same region suggest the same growth enhancing variables? Evidence from selected South Asian countries

We investigate the growth enhancing variables in a group of countries belonging to the same geographical area namely, India, Sri Lanka, Pakistan and Bangladesh over the period 1960-2010. We find that this homogeneity does not necessarily imply that countries have the same growth enhancing variables due mainly to differences in institutions and policies. Our result suggests that time-series econometrics are preferable to identify the growth drivers for a country accurately

An Information Theoretic Criterion for Empirical Validation of Time Series Models

Simulated models suffer intrinsically from validation and comparison problems. The choice of a suitable indicator quantifying the distance between the model and the data is pivotal to model selection. However, how to validate and discriminate between alternative models is still an open problem calling for further investigation, especially in light of the increasing use of simulations in social sciences. In this paper, we present an information theoretic criterion to measure how close models' synthetic output replicates the properties of observable time series without the need to resort to any likelihood function or to impose stationarity requirements. The indicator is sufficiently general to be applied to any kind of model able to simulate or predict time series data, from simple univariate models such as Auto Regressive Moving Average (ARMA) and Markov processes to more complex objects including agent-based or dynamic stochastic general equilibrium models. More specifically, we use a simple function of the L-divergence computed at different block lengths in order to select the model that is better able to reproduce the distributions of time changes in the data. To evaluate the L-divergence, probabilities are estimated across frequencies including a correction for the systematic bias. Finally, using a known data generating process, we show how this indicator can be used to validate and discriminate between different models providing a precise measure of the distance between each of them and the data

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research