L’IMPATTO DEL TERRORISMO SULL’IMMAGINARIO DEL TURISTA. UN’ANALISI DELLE CONVERSAZIONI ONLINE DEI VIAGGIATORI FRANCESI E STATUNITENSI

L’ombra del terrorismo porta a riflettere sui flussi turistici, imponendo un ripensamento delle narrazioni e del marketing delle città e una strategia di contrasto della paura. Il sentimento d’insicurezza è leggibile anche attraverso i dati dell’Osservatorio Europeo sulla Sicurezza che mettono al primo posto la paura degli attacchi terroristici dei cittadini. Il paper si propone di analizzare l’impatto del terrorismo nelle percezioni dei turisti e nelle valutazioni di scelta di una destinazione. Il quadro teorico considera la letteratura scientifica sulla società dell’incertezza, rischio, terrorismo e gli studi sull’evoluzione del processo decisionale del turista e sul ruolo svolto dal web e dai social media. La ricerca si focalizza sulle conversazioni dei turisti americani e francesi aventi ad oggetto il rischio terrorismo a Parigi, nel periodo novembre 2015/settembre 2016, (successivo agli attentati), secondo una metodologia di analisi mista, quali-quantitativa, di text mining e content analysis. Rappresentano oggetto di analisi soltanto le pagine Facebook e i blog più importanti in tema di viaggi e turismo non istituzionali, con l’obiettivo di restituire una rappresentazione realistica del sentiment delle persone intorno al binomio turismo/terrorismo

Major thoracic surgery in Jehovah's witness: A multidisciplinary approach case report

Introduction: A bloodless surgery can be desirable also for non Jehovah’s witnesses patients, but requires a team approach from the very first assessment to ensure adequate planning. Presentation of the case: Our patient, a Jehovah’s witnesses, was scheduled for right lower lobectomy due to pulmonary adenocarcinoma. Her firm denies to receive any kind of transfusions, forced clinicians to a bloodless management of the case. Discussion: Before surgery a meticulous coagulopathy research and hemodynamic optimization are useful to prepare patient to operation. During surgery, controlled hypotension can help to obtain effective hemostasis. After surgery, clinicians monitored any possible active bleeding, using continuous noninvasive hemoglobin monitoring, limiting the blood loss due to serial in vitro testing. The optimization of cardiac index and delivery of oxygen were continued to grant a fast recovery. Conclusion: Bloodless surgery is likely to gain popularity, and become standard practice for all patients. The need for transfusion should be targeted on individual case, avoiding strictly fixed limit often leading to unnecessary transfusion

Effect of treatment with an overheated dry-saturated steam vapour disinfection system on multidrug and extensively drug-resistant nosocomial pathogens and comparison with sodium hypochlorite activity

BACKGROUND: The development of portable steam generators has made disinfection of the environment more practical. This study assessed the "in vitro" ability of an overheated dry-saturated steam vapour system to kill multidrug and extensively-drug resistant nosocomial pathogens, defining the antimicrobial spectrum and the contact times compared with the activity of sodium hypochlorite. METHODS: The antibacterial efficacy of the overheated dry-saturated steam vapour system and of sodium hypochlorite against nosocomial pathogen isolates: extensively drug-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, carbapenemase-producing Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus, high-level aminoglycoside-resistant Enterococcus faecalis, Candida parapsilosis and Aspergillus fumigatus were assessed using a surface time-kill test carried out on glass surfaces, with or without bovine serum albumin (BSA). RESULTS: The bactericidal activity of the overheated dry-saturated steam vapour system was observed at 180°C after 5min contact with or without BSA, using an initial inoculum of 10(9) CFU/mL. To reduce C. parapsilosis and A. fumigatus counts (from 10(7) CFU/mL), a longer contact time was necessary (7min). In vitro tests with sodium hypochlorite at 5% in the absence of an organic substance also resulted in an overall reduction in bacterial counts (from 10(9) CFU/mL) after 5min of treatment. For mycotic challenge (10(7) CFU/mL), a longer contact time was necessary (7min). In the presence of an organic substance, after 5min, the hypochlorite reduced the viable count from 10(9) to 10(5) CFU/mL for all bacterial strains except E. faecalis that showed a reduction of 2 log units (10(9) to 10(7) CFU/mL). For C. parapsilosis and A. fumigatus, a 2 log unit reduction was observed after 7min. CONCLUSIONS: Steam disinfection of environmental surfaces using a portable steam generator is a practical and effective method that is not affected by the presence of organic matter

Bronchial blocker positioning: learning curve and confidence in its use

Despite simple and safe to use and cheap, EZ Blocker remains underused probably because it requires particular skills in recognizing airway and in using fiber- bronchoscopy to check the exact position of their cuffs. Thus, we planned an education training program on the use of EZB for novices in anaesthesia and evaluated the number of procedures required for the acquisition of the skills of this technique

Preoperative optimization with levosimendan in heart failure patient undergoing thoracic surgery

Introduction: We present the case of a patient with dilatative cardiomyopathy waiting for heart transplantation with pleural effusion to be subjected to pleural biopsy, treated with preoperative infusion of levosimendan to improve heart performances. Presentation of case: A 56-year-old man (BMI 22,49) with dilatative cardiomyopathy (EF 18%) presented right pleural effusion. The levosimendan treatment protocol consisted of 24 h continuous infusion (0,1 ug/kg/min), without bolus. The patient was under continuous hemodynamic monitoring prior, during and after levosimendan administration. The surgery for pleural biopsy was performed with uniportal Video Assisted Thoracoscopic approach (VATS). Discussion: A significant increase of Cardiac Index (CI) and Stroke Volume Index (SVI) were observed at 4 h after infusion initiation and was sustained during the next 24 h after the end of infusion. Levosimendan administration was safe. Conclusion: In this case the prophylactic preoperative levosimendan administration is safe and effective in cardiac failure patient undergoing thoracic surgery, but prophylactic preoperative levosimendan treatment in these patients merits further study