Polychlorinated biphenyls, organochlorine pesticides, and polycyclic aromatic hydrocarbons in wild, farmed, and frozen marine seafood marketed in Campania, Italy.

Polychlorinated biphenyls (PCBs), organochlorine pesticides, and polycyclic aromatic hydrocarbons (PAHs) were detected in fresh-catch, farmed, and frozen marine fish marketed in Campania, Italy. Additionally, polychlorobiphenyl congeners were found: six were non-dioxin-like (NDL-PCB) (IUPAC no. 28, 52, 101, 138, 153, and 180), and one was dioxin-like (DL-PCB) (IUPAC no. 118). In all, 93% of fresh-catch, 100% of aquaculture, and 74% of the frozen specimens contained PCBs at concentrations varying from 0.12 to 35.11 ng/g, wet weight; NDL-PCBs ranged between 0.12 and 32.44 ng/g. Penta-, hexa-, and heptachlorobiphenyls were predominant. Regarding organochlorine pesticides, hexachlorobenzene was detected in 35% of fresh catch, 36% of farmed, and 46% of the frozen fish specimens, in a range between < 0.01 and 3.29 ng/g. Contents of the dichlorodiphenyltrichloroethane isomer amounted to 0.12 to 11.00 ng/g. Finally, PAHs were detected in 100% of the specimens. Benzo[a]pyrene was detected in 66% of the aquaculture, 35% of the fresh catch, and 24% of the frozen species, at concentrations varying from 0.03 to 9.18 ng/g. On the basis of annual fish consumption, an average daily intake of NDL-PCBs of 6.02 ng/kg of body weight was estimated. Calculated daily hexachlorobenzene and total dichlorodiphenyltrichloroethane intakes were, respectively, 0.11 and 0.90 ng/kg of body weight per day. The contribution of fish to the daily consumption of the noncarcinogenic PAHs can be considered low; for benzo[a]pyrene, the estimated daily intake is considerably lower than the doses considered carcinogenic for experimental animals by the European Union Scientific Committee on Food

Gli interventi educativi per i pazienti con scompenso cardiaco: una sintesi della letteratura

Patient education is recognized as a central component of heart failure care and reduces hospital readmissions. Nurses have an important role in providing patient education and modifying self-care behaviors. The aim of this article is to examine characteristics of educational interventions for heart failure patients, their measured outcomes and the role of nurses in providing education. We conducted a literature review of the last 10 years and considered 30 articles. Multisession motivational interventions, repeated over time and with different follow-up interventions seem to produce the best results. However, some aspects remain controversial

Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data

Introduction: In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objective(s): The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods: A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results: The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion: NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes

Hospital Discharge: Results From an Italian Multicenter Prospective Study Using Blaylock Risk Assessment Screening Score

PURPOSE:To analyze the predictive validity and reliability of the Blaylock Risk Assessment Screening Score (BRASS) Index in a large group of patients. METHODS: Prospective multicenter observational study was conducted in six Italian hospitals. Data were collected in three phases. FINDINGS: Seven hundred eleven patients were recruited. The mean length of hospitalization for low-risk patients was significantly shorter than those in the medium and high-risk groups. Patients with a BRASS Index lower than 10, unlike those with a higher BRASS Index, were mainly discharged home. CONCLUSIONS: Our results indicate that the BRASS Index is useful to identify patients at risk for prolonged hospitalization. CLINICAL RELEVANCE: The use of a validated BRASS instrument can be useful to screen the patients, improving individual discharge planning

Occurrence of polychlorobiphenyls in buffalo mozzarella cheese from Campania (Italy)

Buffalo milk and mozzarella cheese produced in the Caserta and Salerno areas in Campania region have been investigated on the presence and the levels of polychlorobiphenyls (PCBs). Seven congeners, six non dioxin-like (NDL-PCBs nos. 28, 52, 101, 138, 153 and 180) and one dioxin-like (DL-PCB n. 118), were detected. PCBs were found at detectable levels in the 83% of the buffalo milk and in the 100% of the mozzarella cheese samples from Caserta; in those from Salerno the prevalence of contamination was 77% for milk and 73% for mozzarellas, respectively. The NDL-PCB content of mozzarellas collected in Caserta was significantly higher than that found in those from Salerno. The more diffuse congeners were PCB 28, 138 and 153 both in milk and in mozzarella cheese; PCB 118 contributed to the total PCB content for the 7% in milk and 2-3% in mozzarella cheese. On the basis of the Italian annual average consumption the contribution of mozzarella to the daily dietary intake of NDL-PCB can vary between 0.41 and 21.33 ng kg-1 bw, median value of 3.66 ng kg-1 bw. The levels of contamination in milk and dairies analyzed are similar or quite lower than those found in other European countries

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

Aims: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design: Prospective observational study. Methods: Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as \u2018high frequency.\u2019 Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as \u2018high risk.\u2019 The high-frequency/high-risk category of nursing diagnoses was identified. Results: The sample included 2283 patients. A mean of 4\ub75 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion: Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies

Polychlorinated biphenyls and organochlorine pesticides in seafood from the Gulf of Naples (Italy).

Seven target polychlorinated biphenyls (PCBs; IUPAC nos. 28, 52, 101, 118, 138, 153, and 180) and the organochlorine pesticides (OCPs) hexachlorobenzene (HCB) and dichlorodiphenyltrichloroethane (DDT) and its related metabolites (p,p'-DDT, p,p'-DDE, and p,p'-DDD) were quantified in edible tissues from seven marine species (European hake, red mullet, blue whiting, Atlantic mackerel, blue and red shrimp, European flying squid, and Mediterranean mussel) from the Gulf of Naples in the southern Tyrrhenian Sea (Italy). PCBs 118, 138, and 153 were the dominant congeners in all the species examined. The concentrations of all PCBs (from not detectable to 15,427 ng g(-1) fat weight) exceeded those of all the DDTs (from not detectable to 1,769 ng g(-1) fat weight) and HCB (not detectable to 150.60 ng g(-1) fat weight) in the samples analyzed. The OCP concentrations were below the maximum residue limits established for fish and aquatic products by the Decreto Ministerale 13 May 2005 in all the samples analyzed; therefore the OCPs in the southern Tyrrhenian Sea species are unlikely to be a significant health hazard. Conversely, the mean concentrations of PCBs exceeded (greatly in some cases) the current limits (200 ng(-1) fat weight) set by the European Union for terrestrial foods. Although the manufacture and use of PCBs are banned or highly restricted, these compounds still are important persistent chemical contaminants in the Gulf of Naples

Društvo i ruralna sociologija

Background: Caregivers make an important contribution to the self-care of patients with heart failure (HF), but few instruments are available to measure this contribution. Objective: The objective of this study was to test the psychometric properties of the Caregiver Contribution to Self-care of Heart Failure Index (CC-SCHFI), an instrument derived from the Self-care of Heart Failure Index version 6.2. The CC-SCHFI measures the contribution of caregivers to the self-care maintenance and self-care management of HF patients, as well as their confidence in their ability to contribute to the patients’ HF self-care. Methods: A cross-sectional design was used to study 291 Italian caregivers whose HF patients were cared for in 17 cardiovascular centers across Italy. Caregivers completed the CC-SCHFI and a sociodemographic questionnaire. Caregivers were retested on the CC-SCHFI 2 weeks later to assess test-retest reliability. Results: Most caregivers were women (66%) with a mean age of 59 years. First- and second-order confirmatory factor analysis (CFA) for each CC-SCHFI scale showed good model fit: #2 = 37.22, P = .08, Comparative Fit Index (CFI) = 0.97, Non-Normed Fit Index (NNFI) = 0.96 for caregiver contribution to self-care maintenance (second-order CFA); #2 = 14.05, P = .12, CFI = 0.96, NNFI = 0.93 for caregiver contribution to self-care management (first-order CFA); and #2 = 10.63, P = .15, CFI = 0.99, NNFI = 0.98 for caregiver confidence in contributing to self-care (second-order CFA). The CC-SCHFI was able to discriminate statistical and clinical differences between 2 groups of caregivers who had received or not received HF self-care education. Internal consistency reliability measured by factor score determinacy was more than .80 for all factors and scales except for 1 factor in the caregiver contribution to self-care management scale (.65). Test-retest reliability computed by intraclass correlation coefficient was high (90.90) for most factors and scales. Conclusion: The CC-SCHFI showed good psychometric properties of validity and reliability and can be used to measure the contribution of caregiver to HF patient self-care

First narrow-band search for continuous gravitational waves from known pulsars in advanced detector data

Spinning neutron stars asymmetric with respect to their rotation axis are potential sources of continuous gravitational waves for ground-based interferometric detectors. In the case of known pulsars a fully coherent search, based on matched filtering, which uses the position and rotational parameters obtained from electromagnetic observations, can be carried out. Matched filtering maximizes the signalto- noise (SNR) ratio, but a large sensitivity loss is expected in case of even a very small mismatch between the assumed and the true signal parameters. For this reason, narrow-band analysis methods have been developed, allowing a fully coherent search for gravitational waves from known pulsars over a fraction of a hertz and several spin-down values. In this paper we describe a narrow-band search of 11 pulsars using data from Advanced LIGO’s first observing run. Although we have found several initial outliers, further studies show no significant evidence for the presence of a gravitational wave signal. Finally, we have placed upper limits on the signal strain amplitude lower than the spin-down limit for 5 of the 11 targets over the bands searched; in the case of J1813-1749 the spin-down limit has been beaten for the first time. For an additional 3 targets, the median upper limit across the search bands is below the spin-down limit. This is the most sensitive narrow-band search for continuous gravitational waves carried out so far