FMECA methodology applied to two pathways in an orthopaedic hospital in Milan.

INTRODUCTION: Adverse events pose a challenge to medical management: they can produce mild or transient disabilities or lead to permanent disabilities or even death; preventable adverse events result from error or equipment failure. METHODS: IRCCS Istituto Ortopedico Galeazzi implemented a clinical risk management program in order to study the epidemiology of adverse events and to improve new pathways for preventing clinical errors: a risk management FMECA-FMEA pro-active analysis was applied either to an existing clinical support pathway or to a new process before its implementation. RESULTS: The application of FMEA-FMECA allowed the clinical risk unit of our hospital to undertake corrective actions in order to reduce the adverse events and errors on high-risk procedure used inside the hospitals

Implementação do algoritmo em Matlab® do método de diagonalização filtrada para análises de sinais de ressonância magnética nuclear.

No título, em Matlab® o símbolo é sobrescrito

Revitalizing agriculture: next-generation genotyping and -omics technologies enabling molecular prediction of resilient traits in the Solanaceae family

This review highlights -omics research in Solanaceae family, with a particular focus on resilient traits. Extensive research has enriched our understanding of Solanaceae genomics and genetics, with historical varietal development mainly focusing on disease resistance and cultivar improvement but shifting the emphasis towards unveiling resilience mechanisms in genebank-preserved germplasm is nowadays crucial. Collecting such information, might help researchers and breeders developing new experimental design, providing an overview of the state of the art of the most advanced approaches for the identification of the genetic elements laying behind resilience. Building this starting point, we aim at providing a useful tool for tackling the global agricultural resilience goals in these crops

Cell wall remodeling mediated by specific PME genes plays a role in grapevine response to Botrytis cinerea

Botrytis cinerea (Bc) is one of the main pathogens affecting the cultivated grapevine. A key role in grapevine tissue colonization is played by cell wall (CW) remodeling driven by CW Modifying Enzymes (CWMEs), expressed both by the host and the pathogen. Their action can impact CW integrity and trigger specific immune signaling, thus influencing Bc infection outcome. To further characterize the role of the CW in the grapevine response to Bc, two contrasting genotypes in their resistance to the fungus were artificially inoculated at full bloom. RNA-seq analysis and biochemical characterization of the CW and its modification in samples collected at 24 hours post-inoculation highlighted significant differences between genotypes. A gene set enrichment analysis indicated several over-represented categories upon infection, with a general down-regulation of those genes related to CW organization and pectin modification, mostly in the resistant genotype. Within the down-regulated CWMEs, Pectin Methyl-Esterase (PME) genes were found highly represented. Unlike, VviPME10 was significantly induced upon infection and was further characterized since its putative ortholog in Arabidopsis was associated with resistance to Bc. VviPME10 promoter hosts several predicted binding sites for VviWRKY3, a defense-associated transcription factor, as highlighted by DAP-seq analysis. This evidence is under confirmation by luciferase assays. In addition, the artificial inoculation with Bc of leaves from six VviPME10 knock-out (KO) edited lines showed significantly larger lesion areas when compared to control plants at 5 dpi. Together, these results suggest that pectin modification, mediated by VviPME10, plays an important role in the grapevine response to Bc

The Italian midwifery core outcome set (M-COS) for healthy childbearing women and newborns: Development and initial validation study

Objective This study aimed to develop and validate a midwifery core outcome set (M-COS) for Italian settings based on a salutogenic framework of maternity care. Design A multi-phase and multi-method study was performed. In phase one, we conducted a literature review to identify a preliminary set of outcomes sensitive to midwifery care. In phase two, the qualitative and quantitative content validity of the M-COS was tested. Finally, in the third phase, construct validity was explored through a cross-sectional study to assess the psychometric properties of the M-COS through exploratory and confirmative factor analysis. This study was conducted from December 2019 to April 2020 in Italy. Participants Three main groups of experts/midwives were involved. Group One (n = 10) was involved in the content validity phase, while the other two groups (Group Two and Group Three) were involved in the construct validity phase (n = 300). Results The M-COS includes six outcome domains and thirty-one core outcomes perceived as sensitive to midwifery care, namely: mortality and morbidity (n = 6 outcomes), childbirth (n = 3), postnatal period (n = 6), maternal health (n = 11), maternal-infant bonding (n = 3), and maternal self-care (n = 2). All domains showed good evidence of internal consistency. Conclusion The Italian M-COS is a novel tool that will facilitate the consistent measurement of core outcomes sensitive to midwifery care from the antenatal to the postnatal period in Italian settings. This initial work will be followed by further studies, including validation by service users. Implications for practice The use of the M-COS in clinical practice would facilitate evidence-based data collection and thus contribute to promoting high-quality maternity care

Assessment of the Psychometric Characteristics of the Italian Version of the Nurse Manager Actions Scale

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses’ autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items’ scalability as well as the scale’s validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT = 0.630, Molenaar–Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT = 0.620, Molenaar–Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage

Breastfeeding Self-Efficacy: A Systematic Review of Psychometric Properties Using COSMIN

Background: Breastfeeding self-efficacy has been proven to play a predictive role in enhancing breastfeeding initiation and continuation. Breastfeeding self-efficacy measurement tools have facilitated healthcare professionals’ early identification and support of women at higher risk of early discontinuation of breastfeeding. Research Aim: The aim of this study was to assess the psychometric properties of breastfeeding self-efficacy measurement tools. Method: A systematic review was carried out in three phases. Phase One comprised a systematic literature review performed in PubMed, SCOPUS, Web of Science, and Cochrane Database of Systematic Reviews from February 2021 to January 2023, including 36 studies for final analysis. Phase Two provided a quality appraisal of the psychometric properties of each of the seven breastfeeding self-efficacy measurement tools, according to COnsensus-based Standards for the selection of health Measurement Instrument checklist (COSMIN) guidelines. Phase Three summarized and graded the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) modified approach. Result: The included articles comprised 9,225 participants and seven breastfeeding self-efficacy measurement tools. The Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale – Short Form (BSES-SF), and Prenatal Breastfeeding Self-Efficacy Scale were supported by Grade A evidence sustaining their validity and reliability to assess breastfeeding self-efficacy in the continuum of maternity care. The BSES-SF is the most feasible tool in clinical practice and the most utilized internationally, available in 15 languages. Conclusion: This systematic review provided a Grade A recommendation on breastfeeding measurement tools that will be helpful both for clinical and research purposes

Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase

This study protocol aims to describe the rationale and developmental strategy of the first study in the Italian context which aimed to define a Midwifery Interventions Classification, an evidence-based, standardized taxonomy and classification of midwifery interventions. Midwifery interventions require a specific definition, developed through a consensus-building process by stakeholders to develop the Italian taxonomy of the Midwifery Interventions Classification with the potential for international transferability, implementation, and scaling up. A multi-round Delphi study was designed between June and September 2022, and data collection is planned between February 2023 and February 2024. The developmental phase of the study is based on a literature review to select meaningful midwifery interventions from the international literature, aiming to identify an evidence-based list of midwifery interventions. This phase led to including 16 articles derived from a systematic search performed on PubMed, CINAHL, and Scopus; 164 midwifery interventions were selected from the data extraction performed on the 16 included articles. Healthcare professionals, researchers, and service users will be eligible panelists for the Delphi surveys. The protocol designed a dynamic number of consultation rounds based on the ratings and interim analysis. A nine-point Likert scoring system is designed to evaluate midwifery interventions. Attrition and attrition bias will be evaluated. The results from the study designed in this protocol will inform the development of the Italian taxonomy of the Midwifery Interventions Classification. A shared classification of midwifery interventions will support audit and quality improvement, education, and comparable data collections for research, sustaining public recognition of midwifery interventions to promote optimal maternal and newborn health

Lack of effect of cell-wall targeted antibacterials on biofilm formation and antifungal susceptibility of Candidaspecies

The use of central venous catheters (CVC) and broad-spectrum antibacterials are among the main risk factors for the development of candidemia in patients admitted to intensive care units (ICU). It is known that some antibacterials increase the resistance of these yeasts to azole antifungals. Thus, the aim of this research was to determine whether yeast present in CVC colonizations previously exposed to cell-wall targeted antibacterials benefit from a reduction in susceptibility to fluconazole and voriconazole, facilitating their ability to form biofilms. Candida albicans, C. tropicalis, C. glabrata, C. parapsilosis and C. guilhermondii were seeded into antibacterial (cefepime, meropenem, vancomycin, and piperacillin-tazobactam) gradient plates produced in Mueller-Hinton Agar. The susceptibility to fluconazole and voriconazole and the biofilm formation of the yeasts were tested before and after exposure to the antibacterials. None of the antibacterials exerted a significant effect on the in vitro susceptibility of the yeasts to the antifungal agents or on their ability to form biofilms. These results suggest that increased candidemia in ICU patients is not attributable to possible alterations in the yeasts, but is more likely caused by a weakening of the patient's general condition after long exposure to infection