Combining Core Training and Sensory Refinement: effects on physical performance

The concept of “the Core” describes the complex of anatomical components of the trunk, pelvis and shoulder girdle that are responsible for maintaining the stability of the spine and pelvis and are critical for the transfer of energy from larger torso to the smaller extremities, during many sport and daily-living activities (1). This concept rooted in sport science and rehabilitation and recently Core Training (CT) became very popular as a method to prevent injuries and improve sport performance and physical fitness. It consists in the progressive training of the musculature of the Core with special emphasis in posture and lumbar spine stability. This aspect requires a fine coordination and body awareness that often are poor developed or regressed after an injury. Then, it is important to include exercises of Sensorial Refinement (SR) that may stimulate the refinement of perceptually neglected areas (2). The aim of the study was to evaluate the effect of combined CT and SR on physical performance and to compare these effects with traditional core training. Furthermore, the effect on retention after 4 weeks of detraining was evaluated. Two groups of participants were recruited (age >30 < 50) and assigned to experimental (CT and SR: EXP, n = 9) or control (CT: CON, n = 9) group. Both groups trained ten weeks, with a frequency of two sessions per week. Training consisted in 10’ of warm up, 40’ of workout and 10’ of cool down. Workout of EXP group consisted in 20’ of SR and 20’ of CT whereas CON group performs 40’ of CT. Participants where tested by: Star Excursion Balance Test (SEBT) for the dynamic balance of lower body, Upper Quarter Y Balance Test (YBT-UQ) to assess upper extremities function in a closed-chain position and McGill test to evaluate muscular endurance of the core. Both groups improved core endurance after training and worsen it at follow up; moreover, both groups ameliorate upper an lower body control (SEBT and YBT-UQ) after training but only EXP group improved or maintained it at follow up. Since the information about the movements of the body are elaborated in the somatomotor cortex for fine coordination, the combination of CT and SR should better promote the consolidation of motor memory and long-term body control

Adrenal Modulation & Perceived Distress of BC Survivors

Background: Distress and adrenal balance of breast cancer survivors (BCS) are key elements of their psychophysical health, and increasing evidence has shown both physical exercise and the natural environment are effective for their modulation. The aim of the study was to evaluate the acute effects of the environment and type of light intensity workouts, on distress, salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S) in BCS.Methods: Twenty-four BCS participated in six different workouts, each with the same duration and intensity. Three of them were conducted in natural environments – walking (Wnature), canoeing with assistance (Cnature) and a mix of myofascial and yoga exercises (MYnature). The others were conducted in an urban environment, namely walking (Wurban), or an indoor environment, namely mobilisation and light upper body exercises (MCgym) and a mix of myofascial and yoga exercises (MYgym). Before and after each workout, the Distress Thermometer was completed and saliva was collected.Results: Workouts practised in natural environments elicited a higher reduction in cortisol and the cortisol to DHEA-S ratio and a greater DHEA-S increase compared with workouts practised in urban and indoor environments. Overall, Cnature and MYnature were the best activities; among those practised in urban and indoor environments, MYgym elicited the best results. Distress was not acutely reduced after Wurban and MCgym. Conclusion: Natural environments seem to provide the best management of distress, cortisol, DHEA-S and their balance when working out at light intensities. The simultaneous presence of forests and rivers seems to be the key element of the observed results

Relazioni tra nurse staffing e nursing outcomes: revisione narrativa della letteratura

Introduzione: La misura degli indicatori sensibili alle cure infermieristiche rappresenta un elemento fondamentale del "management sanitario" per la valutazione dell'appropriatezza e della qualití  degli interventi assistenziali, soprattutto negli ospedali per acuti. Obiettivo: Evidenziare in che modo alcune variabili connesse al "nurse-staffing" possono determinare la qualití  dei processi e degli esiti assistenziali correlati ai pazienti. Metodo: È stata condotta una revisione narrativa della letteratura internazionale sui lavori che hanno indagato le possibili correlazioni tra le caratteristiche del nurse-staffing e gli esiti assistenziali dei pazienti, considerando fonti primarie e secondarie, sia in lingua inglese che in italiano, senza limiti temporali. Risultati: Le strategie di ricerca bibliografica utilizzate hanno prodotto la restituzione di n. 4244 lavori, di cui 56 sono risultati rilevanti ai fini degli obiettivi della revisione. L'analisi dei contenuti degli articoli esaminati ha consentito di classificare i risultati della ricerca in tre specifici ambiti: 1) Determinanti di efficacia e di qualití  dell'azione del nursing; 2) Effetti diretti dell'azione del nursing sugli esiti assistenziali; 3) Effetti indiretti dell'azione del nursing sugli esiti assistenziali. Conclusioni: I risultati della letteratura selezionata confermano l'esistenza di una relazione non trascurabile tra le componenti principali del "nurse-staffing" e gli esiti diretti ed indiretti sui pazienti anche se studi longitudinali sarebbero auspicabili per dare maggiore forza all'evidenza dei risultati fin qui ottenuti e per dimensionare più accuratamente il peso delle possibili variabili predittive degli esiti assistenziali correlati all'azione del nursing. Parole chiave: organico infermieristico; qualití  dell'assistenza infermieristica; esiti assistenziali; eventi avversi.Relationship between nurse staffing and nursing outcomes: a narrative review of literatureABSTRACTIntroduction: The measurement of nursing sensitive outcomes represents a fundamental element in "Health Management" in order to assess the suitability and quality of care given, particoulaly in hospitals for the acutely ill. Objectives: To highlight how some variables connected with nurse-staffing can determine the quality of processes and the care outcomes. Methods: A narrative review of international literature has been carried out on investigating possible correlation between nurse-staffing characteristics and care outcomes regarding patients, taking into account primary and secondary sources, written either in English or Italian, without time limits. Results: 4244 articles were retrived, of these 56 were analyzed. Articles were categorized into 3 specific areas: 1) Which aspects determine the efficacy and quality of nursing care; 2) The direct effects of nursing care on care outcomes; 3) The indirect effects of nursing care on care outcomes. Conclusion: Results confirm the existence of a noticeable relationship between the main components of nurse-staffing and the direct and indirect outcomes on patients health. Longitudinal studies shound be carried out highlighting the results obtained up till now even more and assist in accurately measuring the importance of possible predictive variables on care outcomes correlated to nursing care.Key words: nursing staff (MeSH); quality of nursing care; patients' outcomes; adverse events

The use of Leptodyctium riparium Hedw. in the estimation of minimum postmortem interval.

The estimation of the postmortem interval (PMI) is still one of the most challenging issues in forensic investigations, especially in cases in which advanced transformative phenomena have taken place. The dating of skeletal remains is even more difficult and sometimes only a rough determination of the PMI is possible. Recent studies suggest that plant analysis can provide a reliable estimation for skeletal remains dating, when traditional techniques are not applicable. Forensic Botany is a relatively recent discipline that includes many sub-disciplines such as Palynology, Anatomy, Dendrochronology, Limnology, Systematic, Ecology and Molecular Biology. In a recent study, Cardoso et al. (21) used botanical evidence for the first time to establish the PMI of human skeletal remains found in a forested area of northern Portugal from the growth rate of mosses and shrub roots. The present paper deals with a case in which the study of the growth rate of the bryophyte Leptodyctium riparium (Hedw.) Warnst, was used in estimating the PMI of some human skeletal remains that were found in a wooded area near Perugia, in Central Italy

Violenza intrafamiliare: un’indagine casistica sulle sentenze del Tribunale di Terni dal 1985 al 2005

This work, using as source of data the Registries of Court’s Judgement of Terni from 1985 to 200 is to be considered as a study based on the observation of domestic violence in the district of Terni in the last twenty years and as a starting point to improve a consideration on a social problem on the increase but still hidden, and on the need to get ready with suitable secondary prevention’s plan on behalf of Social Control’s Office and Institutions. Results allow for outlining a gross portrayal of aggressors and victims of such a crime, offering instruments to identify those subjects who are considered to be prospective authors or victims of such a violence; moreover data allow to sketch out the main features of the crime itself, thus allowing for a comparison with the national position, to estimate the need to improve specific and autonomous prevention and intervention plans at regional level.L’indagine presentata, utilizzando come fonte di notizie i Registri delle Sentenze del Tribunale di Terni relativi al periodo compreso fra il 1985 ed il 2005, si configura come uno studio epidemiologico-osservazionale delle violenze intrafamiliari nel territorio ternano negli ultimi venti anni e vuole essere di spunto per una riflessione su un problema sociale sempre più dilagante ma ancora estremamente nascosto, nonché sulla necessità dell’attuazione di un più appropriato piano di prevenzione secondaria da parte delle Agenzie di Controllo Sociale e delle Istituzioni. I risultati ottenuti dalla casistica esaminata ci hanno permesso di delineare un generico profilo sia degli autori che delle vittime del reato, offrendo di conseguenza gli strumenti per individuare i soggetti più a rischio; è stato inoltre possibile definire le principali caratteristiche del delitto per permettere un confronto con il quadro definito a livello nazionale, allo scopo di valutare la necessità o meno di piani di prevenzione e di intervento territoriali mirati e autonomi

Trace DNA Transfer in Co-Working Spaces: The Importance of Background DNA Analysis

The presence of background DNA (bgDNA) can hinder the evaluation of DNA evidence at the activity level, especially when the suspect is expected to be retrieved due to their habitual occupation of the investigated environment. Based on real-life casework circumstances, this study investigates the prevalence, composition, origin, and probable transfer routes of bgDNA found on personal items in situations where their owner and person of interest (POI) share the same workspace. Baseline values of bgDNA were evaluated on the participants’ personal items. Secondary and higher degree transfer scenarios of non-self DNA deposition were also investigated. The DNA from co-workers and co-inhabiting partners can be recovered from an individual’s personal belongings. Non-self DNA present on the hands and deposited on a sterile surface can generate uninformative profiles. The accumulation of foreign DNA on surfaces over time appears to be crucial for the recovery of comparable profiles, resulting in detectable further transfer onto other surfaces. For a thorough evaluation of touch DNA traces at the activity level, it is necessary to collect information not only about DNA transfer probabilities but also about the presence of the POI as part of the ‘baseline’ bgDNA of the substrates involved

La violenza sessuale sui minorenni: indagine sulle denunce pervenute alla Procura della Repubblica presso il Tribunale per i minorenni di Perugia dal 1991 al 2006

The present survey emerges from the need to investigate a very complex phenomenon, that is sexual abuse of minors, pedophilia and crime against children and teenagers in general. The aim of the study was to deal with this topic, which has in recent years been given much attention by the media and public opinion, from a scientific point of view. Apart from the difficulties in defining and making diagnosis of sexual violence, the statistical-epidemiological aspects were problematic due to both the complexities in collecting data on this crime and evaluating the actual extent of the phenomenon. Considering the complex nature there of the main target of this investigation was to outline the Umbrian situation as accurately as possible by comparing it with the results of other national and international surveys in order to learn more about this phenomenon. Cases of sexual violence against minors reported to the police from 1991 to 2006 and filed in the Public Prosecutor’s Office at the Juvenile Court in Perugia were consulted. It has emerged from this research that the situation in Umbria partially reflects other Italian and international statistical data and in some aspects diverges from them.La presente indagine nasce dall’esigenza di far luce su un fenomeno altamente complesso e per molti aspetti ancora oscuro e di rispondere mediante rilevazioni scientifiche alla grande attenzione rivolta negli ultimi anni dai mezzi di comunicazione e dall’opinione pubblica a temi come gli abusi sessuali sui minorenni, la pedofilia e più in generale i delitti contro l’infanzia e l’adolescenza. Alle difficoltà definitorie e diagnostiche si affiancano quelle di origine statisticoepidemiologica, legate sia alle complicazioni nel reperimento dei dati relativi a questo reato, sia alla valutazione dell’entità reale del fenomeno.Alla luce di tale complessità, l’obiettivo principale di questa indagine è quello di tracciare un quadro quanto più fedele possibile della realtà umbra, comparandolo con quanto emerso da altre ricerche nazionali ed internazionali, allo scopo di raggiungere una maggior conoscenza del fenomeno. A tale finalità sono stati consultati i fascicoli relativi alle denunce di violenze sessuali sui minori pervenute dal 1991 al 2006 alla Procura della Repubblica presso il Tribunale per i Minorenni di Perugia. Da questo studio condotto sulle denunce di violenze sessuali su minorenni degli ultimi 16 anni nella regione Umbria deriva un quadro del fenomeno parzialmente corrispondente a quanto emerso da altre ricerche nazionali ed internazionali e per alcuni aspetti peculiare

The Role of [18F]F-Choline PET/CT in the Initial Management and Outcome Prediction of Prostate Cancer: A Real-World Experience from a Multidisciplinary Approach

Initial staging of prostate cancer (PCa) is usually performed with conventional imaging (CI), involving computed tomography (CT) and bone scanning (BS). The aim of this study was to analyze the role of [18F]F-choline positron emission tomography (PET)/CT in the initial management and outcome prediction of PCa patients by analyzing data from a multidisciplinary approach. We retrospectively analyzed 82 patients who were discussed by the uro-oncology board of the University Hospital of Ferrara for primary staging newly diagnosed PCa (median age 72 (56&ndash;86) years; median baseline prostate specific antigen (PSA) equal to 8.73 ng/mL). Patients were divided into three groups based on the imaging performed: group A = only CI; group B = CI + [18F]F-choline PET/CT; group C = only [18F]F-choline PET/CT. All data on imaging findings, therapy decisions and patient outcomes were retrieved from hospital information systems. Moreover, we performed a sub-analysis of semiquantitative parameters extracted from [18F]F-choline PET/CT to search any correlation with patient outcomes. The number of patients included in each group was 35, 35 and 12, respectively. Patients with higher values of initial PSA were subjected to CI + PET/CT (p = 0.005). Moreover, the use of [18F]F-choline PET/CT was more frequent in patients with higher Gleason score (GS) or ISUP grade (p = 0.013). The type of treatment performed (surgery n = 33; radiation therapy n = 22; surveillance n = 6; multimodality therapy n = 6; systemic therapy n = 13; not available n = 2) did not show any relationship with the modality adopted to stage the disease. [18F]F-choline PET/CT induced a change of planned therapy in 5/35 patients in group B (14.3%). Moreover, patients investigated with [18F]F-choline PET/CT alone demonstrated longer biochemical recurrence (BCR)-free survival (30.8 months) in comparison to patients of groups A and B (15.5 and 23.5 months, respectively, p = 0.006), probably due to a more accurate selection of primary treatment. Finally, total lesion choline kinase activity (TLCKA) of the primary lesion, calculated by multiplying metabolic tumor volume and mean standardized uptake value (SUVmean), was able to more effectively discriminate patients who had recurrence after therapy compared to those without (p = 0.03). In our real-world experience [18F]F-choline PET/CT as a tool for the initial management of PCa had a relevant impact in terms of therapy selection and was associated with longer BCR-free survival. Moreover, TLCKA of the primary lesion looks a promising parameter for predicting recurrence after curative therapy

Transitare la formazione infermieristica italiana nel periodo post pandemico: le priorità alla luce delle lezioni apprese

Introduzione. Con il ritorno alla normalità, molte attività didattiche sono state ripristinate senza una analisi approfondita di quali trasformazioni attivate nel periodo pandemico dovrebbero essere mantenute e valorizzate. Obiettivo. Individuare le priorità per transitare efficacemente la formazione infermieristica nel periodo post pandemico. Metodo. È stato adottato un disegno qualitativo descrittivo. Un network di nove università ha coinvolto 37 docenti, 28 infermieri tutor/guide di tirocinio e 65 studenti/neolaureati. La raccolta dati è stata effettuata con una scheda semistrutturata; le principali priorità emerse in ogni singola università sono state poi combinate in una visione di insieme. Risultati. Sono emerse nove priorità, tra le quali l’esigenza di: 1. riflettere sulla didattica a distanza per valorizzarne il ruolo complementare a quella in presenza (lezioni/laboratori); 2. ripensare l’apprendimento clinico rifocalizzandone gli obiettivi, la durata, le rotazioni, e le sedi da privilegiare; 3. comprendere come integrare gli spazi di apprendimento virtuale e quelli in presenza nella programmazione didattica; 4. proseguire nelle scelte inclusive e sostenibili. Considerato che la formazione infermieristica è essenziale per il Paese, è prioritario elaborare un piano educativo pandemico capace di garantirne la continuità in ogni circostanza. Conclusioni. Sono emersi nove ambiti prioritari accomunati dal ruolo sempre più importante della didattica digitale; le lezioni apprese, tuttavia, indicano l’esigenza di attivare una fase intermedia capace di guidare verso la completa transizione della formazione nel post pandemia