From science to adapted patient education in retinal optical coherence tomography: How terminology influences diagnostic understanding

Optical Coherence Tomography (OCT) in retinal imaging has evolved rapidly over the last twenty years. Along with these changes in technology, the nomenclature and relationships between healthcare professionals and patients have changed as well. How to translate the complex language of the field such that patients can understand it better is the focus of this paper

WOULD YOU TRUST AN ITALIAN POLITICIAN? PRELIMINARY EVIDENCE FROM ITALIAN REGIONAL POLITICS

This paper evaluates the erosion of electoral accountability of the "Governors" of the Italian Regions in three subsequent political moments: 1) the elections; 2) the inaugural speeches of the Governor; 3) their first important policy decision, the long-term regional budget (DPEFR). We use content analysis (Laver et al., 2003) to assess the position of each Governor on a left to right distribution at the moment of the inaugural speeches and of the DPEFR. We then analyze the correlation between the distributions of 1) the electoral results and the inaugural speeches and 2) the inaugural speeches and the DPEFR, under the hypothesis that greater similarity can be interpreted as greater accountability. The analysis detects some erosion of accountability from the elections to the inaugural speeches, and a more serious one from the inaugural speeches to the DPEFR. A series of ANOVA tests suggests that the Region's relative economic position/dependency on transfers from the central governments partly explains such loss of accountability.

Systematic Uncertainties In Constraining Dark Matter Annihilation From The Cosmic Microwave Background

Anisotropies of the cosmic microwave background (CMB) have proven to be a very powerful tool to constrain dark matter annihilation at the epoch of recombination. However, CMB constraints are currently derived using a number of reasonable but yet un-tested assumptions that could potentially lead to a misestimation of the true bounds. In this paper we examine the potential impact of these systematic effects. In particular, we separately study the propagation of the secondary particles produced by annihilation in two energy regimes; first following the shower from the initial particle energy to the keV scale, and then tracking the resulting secondary particles from this scale to the absorption of their energy as heat, ionization, or excitation of the medium. We improve both the high and low energy parts of the calculation, in particular finding that our more accurate treatment of losses to sub-10.2 eV photons produced by scattering of high-energy electrons weakens the constraints on particular DM annihilation models by up to a factor of two. On the other hand, we find that the uncertainties we examine for the low energy propagation do not significantly affect the results for current and upcoming CMB data. We include the evaluation of the precise amount of excitation energy, in the form of Lyman-alpha photons, produced by the propagation of the shower, and examine the effects of varying the Helium fraction and Helium ionization fraction. In the recent literature, simple approximations for the fraction of energy absorbed in different channels have often been used to derive CMB constraints: we assess the impact of using accurate versus approximate energy fractions. Finally we check that the choice of recombination code (between RECFAST v1.5 and COSMOREC), to calculate the evolution of the free electron fraction in the presence of dark matter annihilation, introduces negligible differences.Comment: 29 pages, 21 figure

Comparing the growth effects of marginal vs. average tax rates and progressivity

The paper compares the appropriateness and explanatory power of marginal tax rates, average tax rates and tax progressivity as measures of the impact of taxation on growth. Data are organized as a panel of 25 industrialized countries from 1970 to 1998. Contrary to previous empirical research, but consistently with theory, we find that marginal effective tax rates and tax progressivity have a negative influence on economic growth. This negative correlation turns out to be robust after controlling for state and policy variables. Average tax rates, on the other hand, seem not to affect output dynamics. © 2002 Published by Elsevier Science B.V

Service life of shotcrete : investigation on the effect of set accelerating admixture

Le béton projeté par voie humide est une méthode de mise en place très populaire dans la construction de tunnels et le soutènement de parois dans les mines. L'utilisation d’un adjuvant accélérateur de prise offre des avantages significatifs en gain de productivité et pour la sécurité des travailleurs pendant la réalisation du travail. Cependant, l’effet de ces adjuvants, et particulièrement leur dosage, sur la durée de vie du béton projeté est mal compris et souvent négligé. Le dosage de l’adjuvant en chantier est souvent élevé, ce qui a pour conséquence de faire augmenter les coûts de production et réduire la qualité du béton. Cette recherche a pour objectif d’étudier l'influence de l'utilisation des accélérateurs de prise sur la durabilité du béton comme matériau, en considérant les particularités du béton projeté et en profitant des avancées faites en matière de prédiction de la durée de vie des bétons conventionnels. L’effet d’un adjuvant accélérateur de prise (à différents dosages) à base de sulfate d’aluminium (A/$) sera étudié. Les résultats permettront d’améliorer la qualité des applications de béton projeté dans l'industrie de la construction et les devis qui, chaque jour, sont plus exigeants et requièrent des performances de plus en plus élevées. Les données générées à partir des différents essais réalisés sont très intéressantes, car elles démontrent la complexité d’une telle étude à cause des changements non proportionnels des caractéristiques du béton avec différents dosages d’accélérateur de prise. De plus, les données générées illustrent bien l'influence de l’adjuvant accélérateur de prise sur la qualité du béton.Wet-mix shotcrete is a widely used placement method in tunnelling and ground support. The use of a set accelerating admixture provides significant advantages in terms of productivity gains and worker safety during work progress. However, knowledge about adverse effects linked the use of set accelerator admixture (and particularly its dosage) is very limited. Indeed, dosage control is sometimes overlooked on the job site or the accelerator may be misguidedly overdosed, with the consequence of increasing costs and reducing the quality of the in-place shotcrete. The goal of this research is to study and better understand the effects of the use of set accelarating admixture on the durability of concrete as a material, starting with the particularities of shotcrete and taking advantage of the latest tools in modelling service life of conventional concretes. An alkali-free set accelerating admixture (at different dosages) based on aluminium-sulphate salts (A/$) will be investigated. The results will help improve the quality of shotcrete applications in the construction industry, and specifications which are increasingly demanding and require everimproving performances. The data generated from the several tests performed is very interesting, because it shows the intricacies of such an investigation due to the non-linear changes of concrete using different set accelerator dosages. It also demonstrates clearly the effects of using high dosages of set accelerating admixtures on the quality of shotcrete

The Leaderbuild Theory.

In the last two years, due to the COVID-19 pandemic, many educational and academic activities have undergone numerous changes; the number of online educational activities, e-Learning, and blended learning have radically increased, and the need to train personnel quickly and with increasing specialist skills has increased. The inclusion of the ‘Leaderbuild’ and ‘Leaderfit’ concept thus becomes one of the factors useful to prepare professionals specialized in every field, ready to lead in every modern environment and need, with structured leadership

Revisión del ciclo de Gibbs. Las emociones como parte del ciclo

The Gibbs' cycle, used in reflective practice, is a tool for self-reflection, mental wellbeing monitoring, academic learning and teaching activities, personal and professional development. It is structured in six phases: description, feelings, evaluation, conclusions, and action plan. Considering well-being and mental health as fundamental players in development paths (academic, professional, human), it becomes important to consider emotions in a new structure of the Gibbs' model. The narrative review is based on the observation of twenty manuscripts, in which the consideration and analysis of emotions in the reflective cycle was sought.El ciclo de Gibbs, utilizado en la práctica reflexiva, es una herramienta para la autorreflexión, el control del bienestar mental, las actividades académicas de enseñanza-aprendizaje, y el desarrollo personal y profesional. Se estructura en varias fases: descripción, sentimientos, evaluación, conclusiones y plan de acción. Considerando el bienestar y la salud mental como actores fundamentales en las trayectorias de desarrollo (académico, profesional, humano), resulta importante considerar las emociones en una nueva estructura del modelo de Gibbs. La revisión narrativa se basa en la observación de veinte manuscritos, en los que se buscaba la consideración y el análisis de las emociones en el ciclo reflexivo

Contributo per una conoscenza analitica delle Mura Bolognesi: Il rilievo critico

Per la prima volta viene affrontato in modo critico e definito il rilievo diretto delle mura e delle porte della terza cerchia di Bologna. La restituzione grafica del testo architettonico è fondamentale non solo per gli studi sui materiali e sulle tecniche che compongono i vari manufatti afferenti al sistema fortificato, ma anche per una lettura cronologica delle stratificazioni che si sono sedimentate nel corso dei secoli. In particolare vengono analizzate direttamente sul testo architettonico le fasi costruttive di Porta Mascarella e Porta San Donato e vengono comparate fra loro cartografie inedite relative alla struttura geometrica delle mura con i relativi elementi accessori, quali cancella, fossato, terrapieni, ecc.

Mental healthcare services support: the social role of medical educator involved in the destigmatization process to generate inclusion.

Introduction: The stigmatization of mental healthcare services and users is a barrier to the achievement of mental wellness present on a global level. 800000 suicides are estimated each year, 25 suicide attempts for every suicide (ratio of 25:1), and in 2017 estimated a prevalence > 10% of people suffering from mental disorder or substance abuse (global data). The stigmatization is a multifactorial phenomenon and process that involves different factors, which overall cause health, social and economic damage. Slowing down and reducing access to mental health and well-being pathways due to their influence in the community, also affect social relationships and self-determination. Purpose: to identify and describe the process, causes, and factors of stigmatization. Propose destigmatization activities led by the medical educator. Methodology: The manuscript develops a proposal focused on the destigmatization process of mental health/wellbeing services and users, through the guidance of the medical educator as a figure of connection between different professions (interdisciplinary and multidisciplinary), and between different stakeholders. Conclusion: each identifies factor described, can be involved in the destigmatization process to generate inclusion, through different social interventions led by the role of the medical educator, with the aim of supporting access to patient support processes and quality of life in communities, generating inclusion through destigmatizatio

Vaccinations in patients with inflammatory bowel disease.

Treatment of inflammatory bowel disease (IBD) frequently requires administration of immunosuppressive therapies, which increases susceptibility to a number of infectious pathogens. However, many infections can be prevented by correct and appropriate utilization of vaccinations. While several guidelines have been published on vaccination schedules in patients with IBD, vaccination rates remain suboptimal and even lower than those in the general population. This is due to many factors including poor awareness of the importance of vaccines by gastroenterologists and general practitioners as well as potential prejudices of patients regarding the safety and benefits of vaccines. With the aim of increasing awareness about the key role of immunization in the management of patients with IBD, the present review examines the existing literature relating to the main vaccinations and their application in these patients. We also summarize current evidence in order to provide clinicians with an easy source of reference for the principal recommendations for prevention of infectious diseases in patients with IBD. In addition, the recommendations about traveling for IBD patients are briefly explored. Lastly, since it is important for gastroenterologists to be aware of recommendations on vaccination, we recommend implementing educational programs to ensure compliance with current guidelines