A qualitative study on family carers views on how end-of-life communication contributes to palliative oriented care in nursing home.

Background. Although family-centered communication about end-of-life care has been recognized to promote palliative-oriented care in nursing home (NH), how this communication may work is still unknown. Therefore, we explored the mechanisms by which end-of-life communication may contribute to palliative-oriented care in NH from the perspective of bereaved family carers.Methods. A descriptive qualitative design was performed. Interviews were conducted with 32 bereaved family carers whose relative had died between 45 days to 9 months prior from 13 different NHs. A two-steps analysis process firstly with deductive and then with inductive content analysis was adopted.Results. Four mechanisms by which end-of-life communication contributed to palliative-oriented care were identified: a) promoting family carers understanding about their relative's health conditions, prognosis, and treatments available; b) fostering shared decision-making between healthcare professionals and residents/family carers; c) improving knowledge of residents' preferences; and d) improving knowledge of family carers' preferences.Conclusion. Clear and in-depth communication provides insight into residents' and family carers' preferences for care and treatment at the end-of-life, and increases understanding and shared decision-making

THE DEEP STRUCTURE OF THE L'AQUILA BASIN INVESTIGATED USING ARRAY MEASUREMENTS

We present velocity profiles obtained through surface-wave methods in the historical city of L’Aquila (Italy). The city suffered severe damage (VIII-IX EMS intensity) during the April 6th 2009 Mw 6.3 earthquake. The area is characterized by the deep (up to 300-400 meters) basin of the Aterno river valley filled by lacustrine sediments over limestone bedrock. In downtown L'Aquila an outcropping unit basically composed of stiff conglomerates (Breccia) is over-imposed to ancient lacustrine sediments with a possible velocity inversion at a depth ranging from few tens up to one hundred meters. We deployed five 2-D arrays of seismic stations and 1-D array of vertical geophones in the city center. The 2-D arrays recorded ambient noise, whereas the 1-D array recorded signals produced by active sources. Surface-wave dispersion and spatial autocorrelation curves, calculated using array methods, were inverted through a neighborhood algorithm jointly with the microtremor HVNSR ellipticity. We obtain shear-wave velocity profiles (Vs) representative of the southern and northern sector of downtown L'Aquila. The resulting Vs profiles are used to compare the 1-D transfer functions to aftershock data results. We apply a convolution approach evaluating synthetic time-histories in sites where surface stratigraphy is known and comparing them to recorded strong-motion data

Attainment of quiet standing in humans: Are the lower limb joints controlled relative to a misaligned postural reference?

In human quiet standing, the relative position between ankle joint centre and line of gravity is neurally regulated within tight limits. The regulation of the knee and hip configuration is unclear and thought to be controlled passively. However, perturbed standing experiments have shown a lower limb multi-joint coordination. Here, measuring the relative alignment between lower limb joints and the line of gravity in quiet standing after walking, we investigated whether the configuration is maintained over time through passive mechanisms or active control. Thirteen healthy adults walked without following a path and then stood quietly for 7.6 s on a force platform (up to four trials). The transition between initiation and steady-state standing (7.6 s) was measured using motion capture. Sagittal lower limb joint centres' position relative to line of gravity (CoGAP) and their time constants were calculated in each trial. Ankle, knee, and hip joint moments were also calculated through inverse dynamics. After walking, the body decelerated (t = 0.16 s). The ankle and hip joints' position relative to CoGAP measured at two time intervals of quiet standing (Mid = 0.5-0.55 s; End = 7.55-7.6 s) were different (mean ± SEM, CoGAP-Ankle_Mid = 47 ± 4 mm, CoGAP-Ankle_End = 58 ± 5 mm; CoGAP-Hip_Mid = 2 ± 5 mm, CoGAP-Hip_End = -5 ± 5 mm). The ankle, knee, and hip flexion-extension moments significantly changed. Changes in joints position relative to CoGAP and misalignment suggest that joint position is not maintained over 7.6 s, but regulated relative to a standing reference. Higher joint moments at steady-state standing suggest mechanisms other than passive knee and hip regulation are involved in standing. © 2007 - 2019 Frontiers Media S.A. All Rights Reserved

Geopolymer Materials for Low-Pressure Injections in Coarse Grained Soil: Multiscale Approach to the Study of the Mechanical Behaviour and Environmental Impact

The term soil improvement is commonly referred to the modification of soil structure in order to obtain a material with better physical and mechanical properties such as strength, stiffness or permeability. With this purpose, one of the most commonly used applications, particularly in coarse-grained soils, is the low pressure injection of cementitious mixtures. In recent years, there has been a growing demand for solutions with limited environmental impact and limited CO2 emissions and, in this regard, the cement present in the injected grout is evidently the weak point of traditional solutions. In this work, the experimental study of geopolymer materials as a substitute of cement mixture for low-pressure injection for coarse-grained soils improvement is presented. The study started with a focus on the geopolymer fresh mixture properties (density, viscosity, horizontal ellipsis ) and the evolution over the time of the mechanical properties (compression and tensile strength and stiffness) comparing three different mix designs at three different monitoring temperatures. The same evaluations were repeated on sand samples injected with the different types of mixtures previously analyzed. For a selected mix design, a permeation test was carried out under controlled conditions to test the pumpability and effectiveness of geopolymer injection. Finally, to deepen the chemical interaction between the injected mixture and interstitial water, an injection test was carried out using a scaled model of a real injection system. The experimental study carried out was aimed both at the analysis of the characteristics of the geopolymer material and at its physical interaction with coarse-grained soil, passing through the measurement of the mechanical characteristics of the geopolymer material and of the solid sand skeleton mixed with geopolymers. Finally, the possible chemical interaction of the mixtures with groundwater was also evaluated in order to highlight any environmental issues. The results shown provide a preliminary but sufficiently broad picture of the behavior of geopolymer mixtures for low-pressure injection for coarse-grained soil improvement purposes both from physical-mechanical and chemical points of view

A tough egg to crack: recreational boats as vectors for invasive goby eggs and transdisciplinary management approaches

Non-native invasive species are a major threat to biodiversity, especially in freshwater ecosystems. Freshwater ecosystems are naturally rather isolated from one another. Nonetheless, invasive species often spread rapidly across water sheds. This spread is to a large extent realized by human activities that provide vectors. For example, recreational boats can carry invasive species propagules as ‘aquatic hitch-hikers’ within and across water sheds. We used invasive gobies in Switzerland as a case study to test the plausibility that recreational boats can serve as vectors for invasive fish and that fish eggs can serve as propagules. We found that the peak season of boat movements across Switzerland and the goby spawning season overlap temporally. It is thus plausible that goby eggs attached to boats, anchors or gear may be transported across watersheds. In experimental trials we found that goby eggs show resistance to physical removal (90mN attachment strength of individual eggs) and stay attached if exposed to rapid water flow (2.8m s-138 for 1h). When exposing the eggs to air, we found that hatching success remained high (>95%) even after eggs had been out of water for up to 24h. It is thus plausible that eggs survive during pick up, within water and overland transport by boats. We complemented the experimental plausibility tests with a survey on how decision makers from inside and outside academia rate the feasibility of managing recreational boats as vectors. We found consensus that an installation of a preventive boat vector management is considered an effective and urgent measure. This study advances our understanding of the potential of recreational boats to serve as vectors for invasive vertebrate species, and demonstrates that preventive management of recreational boats is considered feasible by relevant decision makers in- and outside academia

Statistics of non-linear stochastic dynamical systems under L\'evy noises by a convolution quadrature approach

This paper describes a novel numerical approach to find the statistics of the non-stationary response of scalar non-linear systems excited by L\'evy white noises. The proposed numerical procedure relies on the introduction of an integral transform of Wiener-Hopf type into the equation governing the characteristic function. Once this equation is rewritten as partial integro-differential equation, it is then solved by applying the method of convolution quadrature originally proposed by Lubich, here extended to deal with this particular integral transform. The proposed approach is relevant for two reasons: 1) Statistics of systems with several different drift terms can be handled in an efficient way, independently from the kind of white noise; 2) The particular form of Wiener-Hopf integral transform and its numerical evaluation, both introduced in this study, are generalizations of fractional integro-differential operators of potential type and Gr\"unwald-Letnikov fractional derivatives, respectively.Comment: 20 pages, 5 figure

Low energy high angular resolution neutral atom detection by means of micro-shuttering techniques: the BepiColombo SERENA/ELENA sensor

The neutral sensor ELENA (Emitted Low-Energy Neutral Atoms) for the ESA cornerstone BepiColombo mission to Mercury (in the SERENA instrument package) is a new kind of low energetic neutral atoms instrument, mostly devoted to sputtering emission from planetary surfaces, from E ~20 eV up to E~5 keV, within 1-D (2x76 deg). ELENA is a Time-of-Flight (TOF) system, based on oscillating shutter (operated at frequencies up to a 100 kHz) and mechanical gratings: the incoming neutral particles directly impinge upon the entrance with a definite timing (START) and arrive to a STOP detector after a flight path. After a brief dissertation on the achievable scientific objectives, this paper describes the instrument, with the new design techniques approached for the neutral particles identification and the nano-techniques used for designing and manufacturing the nano-structure shuttering core of the ELENA sensor. The expected count-rates, based on the Hermean environment features, are shortly presented and discussed. Such design technologies could be fruitfully exported to different applications for planetary exploration.Comment: 11 page

Dreaming Characteristics in Non-Rapid Eye Movement Parasomnia and Idiopathic Rapid Eye Movement Sleep Behaviour Disorder: Similarities and Differences

Background: Speech graph analysis (SGA) of dreams has recently shown promise as an objective and language-invariant diagnostic tool that can aid neuropsychiatric diagnosis. Whilst the notion that dreaming mentations reflect distinct physiologic processes is not new, such studies in patients with sleep disorders remain exceptionally scarce. Here, using SGA and other dream content analyses, we set to investigate structural and thematic differences in morning dream recalls of patients diagnosed with Non-Rapid Eye Movement Parasomnia (NREMP) and Idiopathic REM Sleep Behavior Disorder (iRBD). Methods: A retrospective cross-sectional study of morning dream recalls of iRBD and NREMP patients was undertaken. Traditional dream content analyses, such as Orlinsky and Hall and Van de Castle analyses, were initially conducted. Subsequently, SGA was performed in order to objectively quantify structural speech differences between the dream recalls of the two patient groups. Results: Comparable rate of morning recall of dreams in the sleep laboratory was recorded; 25% of iRBD and 18.35% of NREMP patients. Aggression in dreams was recorded by 28.57% iRBD versus 20.00% in NREMP group. iRBD patients were more likely to recall dreams (iRBD vs NREMP; P = 0.007), but they also had more white dreams, ie having a feeling of having dreamt, but with no memory of it. Visual and quantitative graph speech analyses of iRBD dreams suggested stable sequential structure, reflecting the linearity of the chronological narrative. Conversely, NREMP dream reports displayed more recursive, less stable systems, with significantly higher scores of graph connectivity measures. Conclusion: The findings of our exploratory study suggest that iRBD and NREMP patients may not only differ on what is recalled in their dreams but also, perhaps more strikingly, on how dreams are recalled. It is hoped that future SGA-led dream investigations of larger groups of patients will help discern distinct mechanistic underpinnings and any associated clinical implications

Mobile phone use impairs stair gait: A pilot study on young adults.

Human movement control requires attention to accurately tune motor commands in response to environmental changes. Dual task paradigms are used to test the role of attention on motor performance. Usually the tasks used have little resemblance with every day experience. Here we ask: Does a common cognitive task, such as a mobile phone conversation, compromise motor performance on stairs? Eight young participants negotiated an instrumented seven-step staircase. Stair negotiation while talking on a mobile phone was compared to normal stair negotiation. Stepping parameters, jerk cost (measure of smoothness of locomotion) and step clearance were measured. When talking on a mobile phone, participants' overall body velocity (mean(sd): Ascent 0.534(0.026) vs 0.511(0.024) m/s, Descent 0.642(0.026) vs 0.511(0.024) m/s, No phone/Phone respectively) and cadence decreased significantly (Ascent 75.8(5.8) vs 65.6(4.4) steps/min, Descent 117.4(4.2) vs 108.6(6.0) steps/min, No Phone/Phone respectively). Pelvis and feet jerk cost also changed significantly, mostly decreasing with phone use. Foot clearance did not show significant changes between No Phone and Phone conditions. These pilot results show that, even for young, healthy and cognitively intact individuals, talking on a mobile phone whilst negotiating a staircase induces measurable changes in motor performance. Participants moved slowly but more smoothly, reducing the motor control cost, possibly at the expense of movement accuracy. The reduction in motor performance is likely to be due to the difficulty in integrating the two sub-tasks. These results suggest that even young, healthy individuals show stair gait impairment when simultaneously negotiating stairs and performing another cognitive task, such as talking on the phone