La ricerca finalizzata in Area Medica: approfondimenti assistenziali dell’Associazione A.N.Í.M.O.

Introduzione Il gruppo di ricerca dell’Associazione ANÍMO La ricerca infermieristica Obiettivo del lavoro Metodi Metodologia operativa e ambiti di attività I livelli di approfondimento metodologici • Approfondimento metodologico Evidence-Report il cateterismo vescicale • Approfondimento metodologico Evidence-Report il cateterismo venoso periferico a breve termine • Approfondimento metodologico Evidence-Report il dolore cronico in medicina interna Risultati Evidence-Report: i risultati da Revisioni di Linee Guida • Il cateterismo vescicale a permanenza • Il cateterismo venoso periferico a breve termine • La gestione del dolore cronico in medicina  Evidence-Based Care-sheet: What we know e what we can do • Le lipodistrofie associate alla pratica iniettiva • La nutrizione nel paziente con polimorbilità • Scompenso cardiaco e fine vita • Terapia anticoagulante orale e processi educativi: il ruolo dell’infermiere • La somministrazione di liquidi per via sottocutanea • L’ictus cerebrale: rischi e prevenzione Focus di approfondimento, the most updated research • La somministrazione dei farmaci per os in pazienti disfagici e/o portatori di SNG o PEG • Il dolore cronico nei pazienti con disturbi cognitivi • Le cadute negli anziani • Il monitoraggio dei parametri vitali • Il Lock dei cateteri venosi centrali: quale soluzione? Quali evidenze? • La responsabilità del professionista infermiere nella terapia farmacologica • La mancata aderenza alle prescrizioni: un problema da non sottovalutare in medicina interna • La gestione della stipsi nelle degenze di area medica: ruolo dell’infermiere • La malnutrizione in ospedale • L’uso della contenzione è un indicatore di buona pratica assistenziale e di buona cultura?  • Riposo a letto o mobilizzazione precoce? • L’uso delle checklist in area medica • La flebite da infusione • La sorveglianza infermieristica: una competenza necessaria in medicina interna • Umidità e calore della miscela di aria nei trattamenti di ventilazione non invasiva: quali evidenze? • Diabete, intervento educativo, ruolo dell’infermiere • La terapia anticoagulante e il ruolo dell’infermiere: alcune evidenze • Il ritorno dell’ipodermoclisi: quali evidenze? • Gli aspetti assistenziali prevalenti nelle cure infermieristiche alla persona colpita da ictus • Lo scompenso cardiaco: epidemiologia e interventi assistenziali Conclusioni Bibliografi

Nursing clinical competence in area medica

Introduzione Background • La nursing clinical competence • Il concetto di clinical competence in medicina interna • Declinare e classificare i livelli di competenza • Aree di assistenza nei contesti di area medica   • Il paziente cronico • Scompenso cardiaco • La broncopneumopatia cronica e ostruttiva • La cirrosi epatica • La pancreatite • Il diabete mellito • Il delirium • La depressione • Il paziente critico • L’ipertensione • La trombosi venosa profonda • L’ischemia cerebrale • La disfagia • Gli squilibri idroelettrolitici • Le polmoniti • I sanguinamenti gastro-intestinali • La sepsi • Il monitoraggio cardiaco • La ventilazione non-invasiva • L’ecografia operativa bedside • Somministrazione di terapia e chemioterapia • Le lesioni da pressione • Il dolore • Gli accessi vascolari • Il paziente fragile • La dimissione difficile • Il fine vita Obiettivo Metodi Risultati Conclusioni Bibliografi

Numerical analysis of the screening current-induced magnetic field in the HTS insert dipole magnet Feather-M2.1-2

Screening currents are field-induced dynamic phenomena which occur in superconducting materials, leading to persistent magnetization. Such currents are of importance in ReBCO tapes, where the large size of the superconducting filaments gives rise to strong magnetization phenomena. In consequence, superconducting accelerator magnets based on ReBCO tapes might experience a relevant degradation of the magnetic field quality in the magnet aperture, eventually leading to particle beam instabilities. Thus, persistent magnetization phenomena need to be accurately evaluated. In this paper, the 2D finite element model of the Feather-M2.1-2 magnet is presented. The model is used to analyze the influence of the screening current-induced magnetic field on the field quality in the magnet aperture. The model relies on a coupled field formulation for eddy current problems in time-domain. The formulation is introduced and verified against theoretical references. Then, the numerical model of the Feather-M2.1-2 magnet is detailed, highlighting the key assumptions and simplifications. The numerical results are discussed and validated with available magnetic measurements. A satisfactory agreement is found, showing the capability of the numerical tool in providing accurate analysis of the dynamic behavior of the Feather-M2.1-2 magnet

High-temperature superconducting screens for magnetic field-error cancellation in accelerator magnets

Accelerators magnets must have minimal magnetic field imperfections to reduce particle-beam instabilities. In the case of coils made of high-temperature superconducting (HTS) tapes, the magnetization due to persistent currents adds an undesired field contribution, potentially degrading the magnetic field quality. In this paper we study the use of superconducting screens based on HTS tapes for reducing the magnetic field imperfections in accelerator magnets. The screens exploit the magnetization by persistent currents to cancel out the magnetic field error. The screens are aligned with the main field component, such that only the undesired field components are compensated. The screens are self-regulating, and do not require any externally applied source of energy. Measurements in liquid nitrogen at 77 K show for dipole-field configurations a significant reduction of the magnetic field error up to a factor of four. The residual error is explained via numerical simulations accounting for the geometric defects in the HTS screens, achieving satisfactory agreement with experimental results. Simulations show that if screens are increased in width and thickness, and operated at 4.5 K, field errors may be eliminated almost entirely for the typical excitation cycles of accelerator magnets

A green school for Gaza: Design and thermal performance evaluation.

This paper describes the design and thermal performance evaluation of the first low carbon school building in Palestine. The project is a response to the mounting environmental, energy and infrastructure crisis within the Gaza Strip. The ambition is to provide a better learning environment for the children of Gaza, while also being self reliant in terms of electricity and water requirements. The project has been developed in close collaboration with UNRWA. The school, located in the Khan Younis refugee camp, will host 32 classrooms distributed on three floors for a total capacity of 2050 children divided in two shifts. It relies almost entirely on passive strategies to achieve thermal comfort within the classrooms through the year. The roof is formed from a lightweight external ‘parasol’ shading a concrete deck below. Cylindrical concrete columns contain vertical ventilation shafts leading into solar chimneys at roof level. The classrooms are arranged around a large central shaded courtyard, which provides diffuse daylight and fresh air. The classrooms are naturally ventilated by a combination of cross and stack ventilation via the solar chimneys. The façade presents a high window-to-wall ratio and a series of large Mashrabiyas to reduce the incidence of direct solar radiation in the classrooms. Dynamic thermal performance analysis evaluated the effect of the proposed strategies on temperatures in the occupied classrooms during summer and winter. The study concludes that mechanical cooling of classrooms can be eliminated, and that space heating demand is reduced to below 10kWh/sqm.yr. The residual electricity demand for lighting and power can all be met from the PV installation on the roof of the building. The project is currently under construction and the UNRWA intends to measure temperatures and energy consumption within the building and will report in a future paper on performance in-use

How to Cope with Complexity in Decision-Making: An Application of Fuzzy Qualitative Comparative Analysis in the Triage Process

Qualitative Comparative analysis (QCA) is a method used to test theory-based conditions considering multiple interrelated variables that lead to the same outcome. QCA has been applied in several fields (political, sociological, organizational, and marketing), but recently studies are bridging configurational analysis using fsQCA with complexity theory in sub-disciplines of business and management. This paper aims at highlighting the usefulness of QCA also in decision-making. More specifically, we show how the QCA allow researchers to figure out how the interaction between different factors (individual, organizational, environmental) affect the cognitive heuristic process. The cognitive heuristic process is a shortcut strategy used by an individual to take a decision leveraged on limited information, time and processing capacity. We consider the cognitive heuristic process of Triage, performed by nurses in the Emergency Department. The Triage process requires a complex interaction between nurses and patients within a more or less turbulent environment: verbal information (the patient’s history), visual cues (non-verbal communication), and possibly vital signs, determine the outcome of the decision-making process. Contextual factors (i.e. organizational rules and environmental constraints) and individual nurse’s experience, knowledge, and intuition can cause the variation of nurses’ decision-making in assessing the urgency of any individual patient to receive the care. In addition, we propose some practical implications to improve the Triage process based on the results of the QCA application