Employee satisfaction: strumenti per il miglioramento del clima organizzativo

Employee satisfaction. Sistema di riferimento. Gli obiettivi dell'employee satisfaction. I requisiti dell'employee satisfaction. Metriche. Modelli rappresentativ

Analisi di settore: impianti ecologici

Sotto la definizione di settore degli impianti ecologici, rientrano sia le imprese che progettano ed installano impianti per il disinquinamento a valle dei processi produttivi (abbattimento fumi, trattamento di rifuti solidi industriali), sia che progettano ed installano impianti per ridurre l'impatto ambientale delle attività umane (depurazione acque reflue urbane, trattamento e smaltimento di rifuti solidi urbani)

Prospective validation of the CLIP score: a new prognostic system for patient with cirrhosis and hepatocellular carcinoma

Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) depends on both residual liver function and tumor extension. The CLIP score includes Child-Pugh stage, tumor morphology and extension, serum alfa-fetoprotein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power with that of the Okuda staging system in 196 patients with cirrhosis and HCC prospectively enrolled in a randomized trial. No significant associations were found between the CLIP score and the age, sex, and pattern of viral infection. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP categories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that the CLIP score explained 37% of survival variability, compared with 21% explained by Okuda stage. In conclusion, the CLIP score, compared with the Okuda staging system, gives more accurate prognostic information, is statistically more efficient, and has a greater survival predictive power. It could be useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials as a stratification variable, reducing the variability of results owing to patient selection

Intervista a Franco Giacomazzi, presidente AISM

Raffaele Crispino intervista Franco Giacomazzi, presidente AISM Associazione italiana studi di marketin

Cadmium interference with visual performance in Danio rerio

Sight is the sense mainly used by teleosts to hunt for food and escape predators. As a consequence, the eyes are large and a complex visual behavior has been developed. This consist in a series of ‘instinctive’ responses that the animal puts into action when exposed to a stimulation of visual nature. These mechanisms are potentially threatened by the fact that the eye is an easy target for many xenobiotics: in fact, it is directly exposed to the environment and, also, contains a large vitreal chamber that facilitates contaminants distribution to all its compartments. In the present work, we verified whether cadmium, at environmental concentrations, interferes with the visually mediated behaviors in adult Danio rerio,a model system for behavioral screens since 1970’s. Re-illumination tests were carried out with white and colored lights (red, yellow, green and blue), to test color sensitivity in fish contaminated for 30 days. Results reveal that cadmium exposure induces a marked escape response to all light wavelengths. Parallel light and electron microscope investigations demonstrate that cadmium alters retinal organization: the ion, in particular, induces occasional retinal folding, a marked swelling, especially in the ganglion cell and, most important, induces degeneration among ganglion and inner nuclear layer cells. In conclusion, results indicate that cadmium has detrimental effects on visual behavior and that this probably depends on an altered signals transmission from the photoreceptors to the central nervous system. Further studies are required to fully understand the mechanisms underlying cadmium response in the retina; however, the evidences collected so far clearly indicate that animals living in contaminated sites have a reduced fitness. The implications at the ecological level are obvious

Molecular Epidemiology of Sequential Outbreaks of Acinetobacter baumannii in an Intensive Care Unit Shows the Emergence of Carbapenem Resistance

The molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the medical-surgical intensive care unit (ICU) of a university hospital in Italy during two window periods in which two sequential A. baumannii epidemics occurred. Genotype analysis by pulsed-field gel electrophoresis (PFGE) of A. baumannii isolates from 131 patients identified nine distinct PFGE patterns. Of these, PFGE clones B and I predominated and occurred sequentially during the two epidemics. A. baumannii epidemic clones showed a multidrug-resistant antibiotype, being clone B resistant to all antimicrobials tested except the carbapenems and clone I resistant to all antimicrobials except ampicillin-sulbactam and gentamicin. Type 1 integrons of 2.5 and 2.2 kb were amplified from the chromosomal DNA of epidemic PFGE clones B and I, respectively, but not from the chromosomal DNA of the nonepidemic clones. Nucleotide analysis of clone B integron identified four gene cassettes: aacC1, which confers resistance to gentamicin; two open reading frames (ORFs) coding for unknown products; and aadA1a, which confers resistance to spectinomycin and streptomycin. The integron of clone I contained three gene cassettes: aacA4, which confers resistance to amikacin, netilmicin, and tobramycin; an unknown ORF; and bla(OXA-20), which codes for a class D β-lactamase that confers resistance to amoxicillin, ticarcillin, oxacillin, and cloxacillin. Also, the bla(IMP) allele was amplified from chromosomal DNA of A. baumannii strains of PFGE type I. Class 1 integrons carrying antimicrobial resistance genes and bla(IMP) allele in A. baumannii epidemic strains correlated with the high use rates of broad-spectrum cephalosporins, carbapenems, and aminoglycosides in the ICU during the study period

Molecular epidemiology of sequential outbreaks of Acinetobacter baumannii in an intensive care unit shows the emergence of carbapenem resistance.

The molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the medicalsurgical intensive care unit (ICU) of a university hospital in Italy during two window periods in which two sequential A. baumannii epidemics occurred. Genotype analysis by pulsed-field gel electrophoresis (PFGE) of A. baumannii isolates from 131 patients identified nine distinct PFGE patterns. Of these, PFGE clones B and I predominated and occurred sequentially during the two epidemics. A. baumannii epidemic clones showed a multidrug-resistant antibiotype, being clone B resistant to all antimicrobials tested except the carbapenems and clone I resistant to all antimicrobials except ampicillin-sulbactam and gentamicin. Type 1 integrons of 2.5 and 2.2 kb were amplified from the chromosomal DNA of epidemic PFGE clones B and I, respectively, but not from the chromosomal DNA of the nonepidemic clones. Nucleotide analysis of clone B integron identified four gene cassettes: aacC1, which confers resistance to gentamicin; two open reading frames (ORFs) coding for unknown products; and aadA1a, which confers resistance to spectinomycin and streptomycin. The integron of clone I contained three gene cassettes: aacA4, which confers resistance to amikacin, netilmicin, and tobramycin; an unknown ORF; and blaOXA-20, which codes for a class D -lactamase that confers resistance to amoxicillin, ticarcillin, oxacillin, and cloxacillin. Also, the blaIMP allele was amplified from chromosomal DNA of A. baumannii strains of PFGE type I. Class 1 integrons carrying antimicrobial resistance genes and blaIMP allele in A. baumannii epidemic strains correlated with the high use rates of broad-spectrum cephalosporins, carbapenems, and aminoglycosides in the ICU during the study period