Exploration of the effectiveness and transferability of an English model of health promotion based on participation in singing groups for older adults (Silver Song Clubs) in Italy

Background There is growing interest in the idea that arts and singing have effects on health, wellbeing and quality of life in older individuals. This study assesses the effectiveness and transferability to Italy of an English model of health promotion which promotes wellbeing and quality of life in older people through participation in singing groups (Silver Song Clubs). The model developed in the South East of England has proved to be successful. A recently completed randomized controlled trial (Coulton, et al. in press) demonstrated a significant improvement in mental health with a reduction in measured anxiety and depression for older people living independently. The current study adopted the same measures. Method A mixed method approach was adopted with research divided into two parts; Part A was focused on exploring the status of older people living in Rome, their interest in music and singing today and in the past and in taking part in a singing experience. It also explored how local politicians and social workers see the status of older people. Part B was focused on setting up and evaluating singing groups and gathering information from participants on their experiences of singing. The primary outcome measure was an Italian version of the York SF-12 which provides scores for physical and mental wellbeing. The Italian version of the EQ-5D-3L questionnaire was also employed. Results Results from Part A revealed a highly fragmented Italian family, with widespread poverty and social isolation and a need for emotional support and leisure activities among older people. In Part B, three singing groups were established in different areas of Rome with weekly sessions over a period of three months. Participants completed the standardized measures of health and wellbeing at baseline (n=62), after the singing experience (n=45) and three months later (n=41). After the singing experience, older people showed a statistically significant decrease in their levels of anxiety and depression, but this was not maintained over the three month follow up period. However, a significant improvement was found from baseline to follow up in reported performance of „usual activities‟. Conclusions Silver Song Clubs provide a health promotion model which was successfully transferred from England to the different cultural setting of Italy. Singing can be widely used because it is grounded in a fundamental human ability to engage with music. The present study had a number of limitations, primarily a lack of a control group and small sample size. However it provides a good foundation for the development of further research on singing and the wellbeing of older people in Italy

Tots els embarassos són bessons:un bebè a l’úter i un altre a la ment. Traumes preconceptuals i embaràs

La idea central d’aquest treball és que la dona embarassadaté un bebè imaginari que pot conceptualitzar-se com un bebèbessó del bebè uterí. Exposo la meva teoria sobre el “traumapreconceptual”, el qual fragmenta la ment en dos estatsmentals diferents que es correlacionen dialècticament (“l’estattraumatitzat” i el “no traumatitzat”), i sobre el concepted’autoenveja. En l’estat mental traumatitzat trobem elementsenvejosos tòxics que poden interferir en l’embaràs. Aixòs’il·lustra amb material clínic de l’anàlisi de dues pacients

eHealth literacy scale: a nursing analysis and Italian validation

Background: One of the scales most used to measure quickly and easily eHealth Literacy is the eHealth LiteracyScale (eHEALS); however, there was no validation of this scale in Italian. Therefore, the aim of this study was to adapt and validate the eHealth Literacy Scale (eHEALS) to the italian context. Methods: Italian translation of eHEALS was administered along unit to another two scale for measure lifestyle habits self-esteem and life satisfaction). A sample of 650 university students aged between 18 and 45 years was selected. An exploratory factor analysis, confirmatory factor analysis, analysis of invariance, reliability, stability and bivariate correlations were performed. Results: Exploratory factor analysis revealed a monofactorial structure that explained 67% of variance. Reliability of 0.87 and test-retest correlation of 0.78 was obtained. The questionnaire was invariant by gender. Regarding the criterion validity, a statistically significant and positive correlations between 0.05 and 0.15 with three indicators was obtained (self-esteem, lifestyle habits and life satisfaction). The italian version of the eHEALS tested in this work has shown to be a valid and reliable scale to measure eHealth competence in university students

Prophylactic Use of Liposomal Amphotericin B in Preventing Fungal Infections Early After Liver Transplantation: a Retrospective, Single-Center Study

In this study the authors evaluated the efficacy of prophylaxis with liposomal amphotericin B (L-AmB) in the incidence of fungal infections (FI) during the first 3 months after liver transplant (LT). The study was retrospective and accessed a 4-year period from 2008 to 2011. All patients who died in the first 48 hours after LT were excluded. Patients were divided by the risk groups for FI: Group 1, high-risk (at least 1 of the following conditions: urgent LT; serum creatinine >2 mg/dL; early acute kidney injury [AKI] after LT; retransplantation; surgical exploration early post-LT; transfused cellular blood components [>40 U]); and Group 2, low-risk patients. Group 1 patients were further separated into those who received antifungal prophylaxis with L-AmB and those who did not. Prophylaxis with L-AmB consisted of intravenous administration of L-AmB, 100 mg daily for 14 days. Four hundred ninety-two patients underwent LT; 31 died in the first 48 hours after LT. From the remaining 461 patients, 104 presented with high-risk factors for FI (Group 1); of these, 66 patients received antifungal prophylaxis and 38 did not. In this group 8 FI were observed, 5 in patients without antifungal prophylaxis (P = .011). Three more FI were identified in Group 2. By logistic regression analysis, the categorical variable high-risk group was independently related to the occurrence of invasive FI (P = .006). We conclude that prophylaxis with L-AmB after LT was effective in reducing the incidence of FI. No influence on mortality was detected

L’esperienza dei caregiver primari che assistono a domicilio le persone affette dalla Malattia di Alzheimer [Alzheimer's disease and caregivers experience in home care]

The aim of this study is to investigate the experience of primary caregivers (men and women) of Alzheimer Disease dementia, in order to tailor program and project to avoid care giving burden. A qualitative phenomenological method was used and the sample was defined by data saturation. Interviews were carried out and recorded in a day care Centre, transcribed verbatim. The analysis was conducted coding common themes and phrases. Six main themes emerged. Our results are similar to those existing in literature, showing care givers as individual in great danger physically and mentally. In the light of the study it is possible to tailor a nursing model in order to improve quality of life and decrease the burden of caregivers, this model should be implemented and analyzed

Current state of interventional radiotherapy (brachytherapy) education in Italy: Results of the INTERACTS survey

Purpose: Increased complexity of interventional radiotherapy (brachytherapy - BT) treatment planning and quality control procedures has led to the need of a specific training. However, the details of the features of BT learning objectives and their distribution in the training paths of the Italian Radiation Oncology Schools are not known. This paper aims to provide the actual 'state-of-the-art' of BT education in Italy and to stimulate the debate on this issue.Material and methods: All the Italian radiation oncology schools' directors (SD) were involved in a web survey, which included questions on the teaching of BT, considering also the 2011 ESTRO core curriculum criteria. The survey preliminary results were discussed at the 8th Rome INTER-MEETING (INTERventional Radiotherapy Multidisciplinary Meeting), June 24th, 2017. The present paper describes the final results of the survey and possible future teaching strategies resulting from the discussion.Results: A total of 23 SDs answered the survey. The results evidenced a wide heterogeneity in the learning activities available to trainees in BT across the country. While theoretical knowledge is adequately and homogeneously transmitted to trainees, the types of practice to which they are exposed varies significantly among different schools.Conclusions: This survey proves the need for an improvement of practical BT education in Italy and the advisability of a national BT education programme networking schools of different Universities. Beside the organization of national/international courses for BT practical teaching, Universities may also establish post-specialization courses ('second level' Masters) to allow professionals (already certified in radiation oncology) to acquire more advanced BT knowledge

Community singing, wellbeing and older people: implementing and evaluating an English singing tool for health intervention in Rome

Aim: The aim of this research was to explore the transferability and effectiveness of the English Silver Song Clubs model for older people in a different social and cultural context, i.e. in the capital city of Italy, Rome. Methods: A single condition, pre-test, post-test design was implemented. Participants completed two questionnaires: EQ-5D and York SF-12. Results: After the singing experience, participants showed a decrease in their levels of anxiety and depression. An improvement was also found from baseline to follow up in reported performance of usual activities. The English study showed a difference between the singing and non-singing groups at three and six months on mental health, and after three months on specific anxiety and depression measures. The current (Rome) study shows similar findings with an improvement on specific anxiety and depression items. Conclusions: Policy makers in different national contexts should consider social singing activities to promote the health and wellbeing of older adults as they are inexpensive to run and have been shown to be enjoyable and effective

Preclinical Studies in Anti-Trypanosomatidae Drug Development

The trypanosomatid parasites Trypanosoma brucei, Trypanosoma cruzi and Leishmania are the causative agents of human African trypanosomiasis, Chagas Disease and Leishmaniasis, respectively. These infections primarily affect poor, rural communities in the developing world, and are responsible for trapping sufferers and their families in a disease/poverty cycle. The development of new chemotherapies is a priority given that existing drug treatments are problematic. In our search for novel anti-trypanosomatid agents, we assess the growth-inhibitory properties of >450 compounds from in-house and/or “Pathogen Box” (PBox) libraries against L. infantum, L. amazonensis, L.braziliensis, T. cruzi and T. brucei and evaluate the toxicities of the most promising agents towards murine macrophages. Screens using the in-house series identified 17 structures with activity against and selective toward Leishmania: Compounds displayed 50% inhibitory concentrations between 0.09 and 25 μM and had selectivity index values >10. For the PBox library, ~20% of chemicals exhibited anti-parasitic properties including five structures whose activity against L. infantum had not been reported before. These five compounds displayed no toxicity towards murine macrophages over the range tested with three being active in an in vivo murine model of the cutaneous disease, with 100% survival of infected animals. Additionally, the oral combination of three of them in the in vivo Chagas disease murine model demonstrated full control of the parasitemia. Interestingly, phenotyping revealed that the reference strain responds differently to the five PBox-derived chemicals relative to parasites isolated from a dog. Together, our data identified one drug candidate that displays activity against Leishmania and other Trypanosomatidae in vitro and in vivo, while exhibiting low toxicity to cultured mammalian cells and low in vivo acute toxicity