L'impatto del ruolo delle Emergency Nurse Practitioners nella gestione clinica dei pazienti nel contesto di un Dipartimento di Emergenza Urgenza nel Regno Unito

RIASSUNTOAll'interno di Strutture per la gestione delle Emergenze-Urgenze, diverse figure professionali sanitarie intervengono nella gestione e nel trattamento del paziente che presenta livelli di gravití  clinica diversi. In questo studio si descrive ed analizza il ruolo di figure infermieristiche che hanno acquisito livelli di formazione diversi e che si integrano con lo staff medico nella gestione di pazienti con codici di bassa e media priorití  al trattamento. La metodologia utilizzata è la case study research. Si propongono tre casi clinici gestiti all'interno del Servizio See and Treat e nella Major Area del Wishaw General Hospital, Glasgow, Scozia. Attraverso la descrizione e l'analisi dei casi clinici è possibile fornire elementi di approfondimento e di discussione di modelli di gestione clinica ed organizzativa innovativi, in cui infermieri specializzati si integrano all'interno dell'équipe, in modo non conflittuale assumendo responsabilití  cliniche, oltre che assistenziali in totale o parziale autonomia dal medico. Parole chiave: Emergency Nurse Practitioner, Dipartimento di Emergenza-Urgenza, Servizio "Vedi e Tratta", Pratica infermieristica avanzataABSTRACTVarious professional health figures participate in the management and treatment of patients in Emergency-Casualty structures presenting diverse levels of clinical severity. This study describes and analyses the role of nursing figures who have acheived different levels of training who collaborate with medical staff in the management of low and medium priority patients, using the case study research method. Three cases treated in the See and Treat Service and in the Major Area of the Wishaw General Hospital, Glasgow, Scozia are described.Key words: Emergency Nurse Practitioner, Emergency-Casualty Department, "See and Treat" Service, Advanced Nursin

Operation of the CERN disk storage infrastructure during LHC Run-3

The CERN IT Storage group operates multiple distributed storage systems to support all CERN data storage requirements. The storage and distribution of physics data generated by LHC and non-LHC experiments is one of the biggest challenges the group has to take on during LHC Run-3.EOS [1], the CERN distributed disk storage system is playing a key role in LHC data-taking. During the first ten months of 2022, more than 440PB have been written by the experiments and 2.9EB have been read out. The data storage requirements of LHC Run-3 are higher than what was previously delivered. The storage operations team has started investigating multiple areas to upgrade and optimize the current storage resources. A new, dedicated and redundant EOS infrastructure based on 100Gbit servers was installed, commissioned and deployed for the ALICE Online and Offline (O2) project. This cluster can sustain high-throughput data transfer between the ALICE Event Processing Nodes (EPN) and the CERN’s data center.This paper will present the architecture, techniques and workflows in place allowing EOS to deliver fast, reliable and scalable data storage to meet experiment needs during LHC Run-3 and beyond

Structured and shared CT radiological report of gastric cancer: a consensus proposal by the Italian Research Group for Gastric Cancer (GIRCG) and the Italian Society of Medical and Interventional Radiology (SIRM)

Objectives Written radiological report remains the most important means of communication between radiologist and referring medical/surgical doctor, even though CT reports are frequently just descriptive, unclear, and unstructured. The Italian Society of Medical and Interventional Radiology (SIRM) and the Italian Research Group for Gastric Cancer (GIRCG) promoted a critical shared discussion between 10 skilled radiologists and 10 surgical oncologists, by means of multi-round consensus-building Delphi survey, to develop a structured reporting template for CT of GC patients. Methods Twenty-four items were organized according to the broad categories of a structured report as suggested by the European Society of Radiology (clinical referral, technique, findings, conclusion, and advice) and grouped into three "CT report sections" depending on the diagnostic phase of the radiological assessment for the oncologic patient (staging, restaging, and follow-up). Results In the final round, 23 out of 24 items obtained agreement ( >= 8) and consensus ( 0.05). Conclusions The structured report obtained, shared by surgical and medical oncologists and radiologists, allows an appropriate, clearer, and focused CT report essential to high-quality patient care in GC, avoiding the exclusion of key radiological information useful for multidisciplinary decision-making

Comparing Notes: Recording and Criticism

This chapter charts the ways in which recording has changed the nature of music criticism. It both provides an overview of the history of recording and music criticism, from the advent of Edison’s Phonograph to the present day, and examines the issues arising from this new technology and the consequent transformation of critical thought and practice

Wider Still and Wider: British Music Criticism since the Second World War

This chapter provides the first historical examination of music criticism in Britain since the Second World War. In the process, it also challenges the simplistic prevailing view of this being a period of decline from a golden age in music criticism

Studio e progettazione di un sistema d'accesso alla cavita addominale per applicazioni di chirurgia robotica mininvasiva

Il presente lavoro di tesi, svolto presso il polo Sant’Anna Valdera in collaborazione con l’azienda MicroTech Srl (azienda spin-off della Scuola Sant'Anna) ha come oggetto la progettazione e lo sviluppo di una Porta d’Accesso per la cavità addominale che trova applicazione nell’ambito della chirurgia robotica mininvasiva. Tale dispositivo si sviluppa all’interno di ARAKNES (acronimo di Array of Robots Augmenting the Ki-Nematics of Endoluminal Surgery), progetto iniziato nel Maggio 2008 a cui partecipano, oltre all’azienda MicroTech Srl, un importante gruppo di università e aziende europee. ARAKNES prevede la realizzazione di un sistema robotico tele operato per chirurgia Single Port, che attraverso un’unica incisione effettuata al livello dell’ombelico, si inserisce ed opera all’interno dell’addome grazie alla Porta d’Accesso, un dispositivo multi-componente costituito da: • Tube: realizzato tramite la colata di silicone in un apposito stampo e da inserire attraverso la parete addominale; • Un sistema Handle-Cap: elementi realizzati in resina Visijet alla stampante 3D, che hanno il compito di chiudere la struttura e mantenere nella giusta posizione il Support-Pipe della telecamera e l’introduttore; • Sistema di ancoraggio alla parete addominale realizzato con due palloncini in silicone, Balloons; • Sistema per il mantenimento del pneumoperitoneo (per tale scopo sono state adottate differenti soluzioni che hanno condotto alla progettazione di molteplici versioni del Tube e del sistema Handle-Cap). La porta d’accesso è stata progettata in modo tale da rispettare le specifiche dettate dal progetto ARAKNES ed i limiti anatomici dei tessuti, inoltre durante l’intero iter progettuale è stato assunto come obbiettivo l’ottimizzazione del rapporto semplicità d’uso/efficienza

The “Forest Fire Project”, National cartographic portal of the Italian Environmental Department: an example of management of cartographic data to support forest fires fighting plans in national parks

The “Forest Fire Project” on the National cartographic portal (http://www.pcn.minambiente.it) has been created by the Italian Ministry of Environment Territory and Sea (METS). The project is intended to support forest fire fighting plans in national protected areas as provided for by article 8 of the law November 21th 2000, no. 353 “Framework law on forest fires”. The project brings out the results of previous projects carried out in collaboration with several research institutes. Cartographic information is made available as free and reliable knowledge base in order to facilitate the draw up and implementation of the “Forest Fire Plans”, including the actual activity of forest fire extinction. Map information can be further implemented by various subjects such as researchers, land planning programmers or managers. The National cartographic portal gives the opportunity of overlaying various cartographic information and base maps supporting the “Forest Fire Project”; moreover it is possible to add other layers from other sources, through URL. Adequate “personalised” overlaps - which can be saved on one’s own GIS - allow in depth analysis and deductions aimed at specific objectives of territorial planning and management and in particular of Forest Fire Fighting Plans