"Prévention de l'épuisement du proche aidant dans des situations de soins palliatifs à domicile: comment l'infirmière accompagne le proche aidant dans l'expérience qui est la sienne, dans une situation de soins palliatifs à domicile, en vue de prévenir son épuisement ?" : revue de la littérature scientifique : travail de Bachelor

Le domaine des soins à domicile est en pleine mutation en Suisse. Les soins palliatifs à domicile sont en pleine croissance, et le nombre de personnels qu’ils nécessiteraient ne peut pas être atteint par les institutions de soins à domicile seules. C’est la raison pour laquelle les proches aidants sont de plus en plus sollicités. Cependant ces personnes sans grande expérience dans les soins palliatifs et dans une étape de transition, ne possèdent pas forcément les stratégies pour se protéger d’un épuisement quasiment certain. Ils doivent ainsi pouvoir bénéficier du soutien adapté et suffisant pour ne pas devenir à leur tour des patients. La théorie de l’Humaindevenant de R. R. Parse décrit la manière dont une personne traverse l’expérience intense que représente une prise en soins palliative à domicile, en prenant en compte l’unicité de la personne et permettant une adaptation fine du système de santé environnant. Les auteurs ont consulté les bases de données scientifiques de références et ont extrait des articles rapportant des exemples de bonnes pratiques. Ils ont analysé ces écrits à la lumière de la théorie de l’Humaindevenant, donnant ainsi des pistes de réflexions utilisables dans la pratique infirmière quotidienne

Recommendations for travelling with bronchiectasis:a joint ELF/EMBARC/ERN-Lung collaboration

Introduction: People with bronchiectasis frequently request specialist advice to prepare for travelling, but there are few publications providing advice on safe travel with bronchiectasis. There is a need for recommendations on adapting everyday treatment to the requirements during travelling.Methods: A panel of 13 patient volunteers formulated questions regarding different aspects of travelling, including safety of travel, maintaining regular treatment during travel, and dealing with deterioration while away. Patient input was used to derive a questionnaire and circulated among a panel of bronchiectasis experts. Where 80% or more experts agreed on a response, a recommendation was made.Results: A total of 26 bronchiectasis experts answered the questionnaire. Recommendations were made on safety of travel, choice of destinations and activities, choice of travel insurance, carrying medications and devices, maintaining regular treatments in transport, documentation to be provided and oxygen requirements. Some statements did not reach an 80% agreement; in many cases these statements may be valid for some, but not all bronchiectasis patients.Conclusions: The general agreement was that it is considered safe for most people with bronchiectasis to travel. Careful planning and preparation with robust communication between patients and their healthcare provider prior to travel for different scenarios is fundamental to a successful journey.</p

CASTLE : map generation and navigation

LAUREA MAGISTRALELa Generazione Procedurale dei Contenuti (PCG) è un campo promettente per il design, la grafica e la produzione dei videogiochi, permettendo la generazione in tempo reale di contenuti, al posto di utilizzarne di pre-generati. In questa tesi, discuteremo l'implementazione di un metodo per la generazione procedurale di mappe 2D e di un algoritmo di navigazione basato sul metodo di ricerca A*. Il generatore di mappe è strutturato in due fasi: la prima si occupa del layout della mappa mentre la seconda della disposizione degli oggetti al suo interno. Entrambi gli algoritmi son stati implementati nel videogioco CASTLE, un gioco sviluppato in collaborazione con l'Università Cattolica del Sacro Cuore di Milano con l'obbiettivo di supportare la ricerca sul pensiero laterale.Procedural Content Generation (PCG) is a promising field for the design, art and production of video games, allowing real-time generation of game contents instead of relying on pre-generated ones. In this thesis, we will discuss our implementation of a procedural generation method for 2D maps and a navigation algorithm based on A*. The map generator is structured in two phases: the first one deals with the map layout while the second one with object placement. Both algorithms have been implemented in the video game CASTLE, a game developed in collaboration with Università Cattolica del Sacro Cuore di Milano to support research about lateral thinking

Characterizing non-tuberculous mycobacteria infection in bronchiectasis

Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a “tree-in-bud” pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research

Catalytic enantioselective reduction of nitroalkenes in DESs

The shift toward sustainable chemical processes that fulfill the principles of green chemistry, is recognized as a priority by the scientific community. In this context, one of the major culprits of waste production in chemical industries is the use of solvents, therefore the study of alternative and environmentally benign solvents is a topic that is gaining a steadily increasing attention. Deep Eutectic Solvents (DESs)1 are mixture of two or three components, typically derived from natural sources, which are capable of forming hydrogen bond interactions with each other, thus leading an eutectic mixture with a melting point lower than either of the individual components. DESs were firstly studied by Abbott2 and co-workers in 2003 and, since then, a considerable number of applications, spanning from metal processing to biodiesel purification, were published. The attention dedicated worldwide to DESs is linked to their unique features, to be easily prepared without the need of further purification, to be non-volatile, non-flammable and biodegradable. In 2016, our research group3 disclosed the possibility to run stereoselective reactions catalyzed by a chiral primary amine in bio-based eutectic mixtures. In particular, three different activation mode based on covalent interaction between the catalysts and the substrate were studied. Herein, we report our efforts for the development of the first organocatalytic reduction involving hydrogen bonding interactions among the substrate, the reagent and the catalyst in deep eutectic solvents which are made in turn of hydrogen bonds. We optimized the reduction of β,β-disubstituted nitroalkenes with Hantzsch ester (di-tert-butyl-1,4-dihydro-2,6-dimethyl-3,5-pyridinedicarboxylate) in the presence of thiourea-based chiral bifunctional catalysts to promote the formation of enantioenriched β-branched nitroalkanes, that was published by List4 and co-workers, employing DESs as reaction medium instead of traditional organic solvents. Several DESs were tested, obtaining the best results with a mixture of choline chloride and glycerol. The reduction protocol involves milder reaction conditions and shorter reaction time with the respect to the original publication and opens the way to the possibility of recycling the DES

Power standard based on a high precision power-factor meter

PostprintA high-precision power-factor meter, based on zero crossing detectors, is proposed. The influence of the distortion in the input signals is analyzed and low pass filters proposed to prevent this error source. This system is proposed as a new power standard meter, based on the measurement of voltage, current and power factor

Teens, Social Media and Technology 2023: YouTube, TikTok, Snapchat and Instagram remain the most widely used online platforms among U.S. teens

Pew Research Center conducted this study to better understand teens' use of digital devices, social media and other online platforms.The Center conducted an online survey of 1,453 U.S. teens from Sept. 26 to Oct. 23, 2023, through Ipsos. Ipsos recruited the teens via their parents, who were part of its KnowledgePanel. The KnowledgePanel is a probability-based web panel recruited primarily through national, random sampling of residential addresses. The survey was weighted to be representative of U.S. teens ages 13 to 17 who live with their parents by age, gender, race and ethnicity, household income, and other categories.This research was reviewed and approved by an external institutional review board (IRB), Advarra, an independent committee of experts specializing in helping to protect the rights of research participants

Metal-free &#945;-trifluoromethylthiolation and &#945;-trifluoromethylselenolation of carbonyl derivatives

The incorporation of a SCF3 or a SeCF3 group into organic molecules is a topic of great interest, especially for the pharmaceutical and agrochemical industries. Due to their high lipophilicity and high electron-withdrawing character (Hansch lipophilicity parameter piR =1.44 (SCF3) vs piR =1.29 (SeCF3)), these moieties represent a powerful opportunity to influence the pharmacokinetics properties of a drug molecule. In the last years, new structural units, rising from the association between chalcogens and fluorinated moieties, have been introduced into carbonyl compounds, as emerging class with potential applications on several fields. New reagents have been developed as sources of electrophilic SCF3 and SeCF3 groups; however, a widespread use of such fluorinated compounds is hampered by the very limited number of strategies available for their preparation. In this contest, we have developed two methodologies for the preparation of alpha-SCF3 and alpha-SeCF3 substituted carbonyl derivatives starting from non activated ketones or their derivatives

Metal-Free Deoxygenation of Chiral Nitroalkanes : An Easy Entry to α-Substituted Enantiomerically Enriched Nitriles

A metal-free, mild and chemodivergent transformation involving nitroalkanes has been developed. Under optimized reaction conditions, in the presence of trichlorosilane and a tertiary amine, aliphatic nitroalkanes were selectively converted into amines or nitriles. Furthermore, when chiral β-substituted nitro compounds were reacted, the stereochemical integrity of the stereocenter was maintained and α-functionalized nitriles were obtained with no loss of enantiomeric excess. The methodology was successfully applied to the synthesis of chiral β-cyano esters, α-aryl alkylnitriles, and TBS-protected cyanohydrins, including direct precursors of four active pharmaceutical ingredients (ibuprofen, tembamide, aegeline and denopamine)

An unusual presentation of pulmonary lymphoma: When diffuse ground glass opacities can mean anything

Primary lung lymphoma (PLL) is a rare type of lymphoma confined to the lung at the time of diagnosis. Pulmonary diffuse large B cells lymphoma (P-DLBCL) is the second most common type of PLL and it usually appears radiologically as solitary or multiple nodules or areas of consolidation. We present the case of a 63-year-old Caucasian male who developed severe acute respiratory failure and diffuse ground glass opacities (GGO) on chest computerized tomography. Diffuse GGO may be the radiological expression of very different diseases, ranging from infectious processes to interstitial lung diseases (ILDs) and neoplastic diseases. In our case, pneumonia and de novo ILD were initially considered given the symptoms and past medical history. However, bronchoscopy with trans-bronchial biopsies demonstrated the presence of P-DLBCL, despite an unusual radiological presentation and negative cytological analyses on bronchoalveolar lavage. In conclusion, P-DLBCL should be considered among the many differential diagnoses of diffuse GGO