Creation & concept: exploring the founders story

Using narrative inquiry, this research project explores the importance of various aspects of leadership, by eliciting seventeen individual autobiographical stories (personal narratives) from founders of successful commercial organisations. As part of the analysis, the findings are explored in an effort to uncover recurrent themes resonating from the stories that the founders / interviewees tell about themselves. The findings are considered in the context of Joseph Campbell’s seminal theory of storytelling (Campbell 1949), as elucidated by Christopher Vogler (2007) in ‘The Writers Journey: Mythic Structure for Writers’, in order to determine whether the founders in this study are, or were, heroes. The project’s participants choose to tell their stories to the researcher in the setting of their choice. The researcher then analyses each founder’s story to identify reoccurring themes, and reflects upon the overall transfer of that experience and the information gathered. Collecting these individual autobiographical stories, listening to and comparing each unique account, and investigating how each personal narrative is constructed around specific events and critical incidents, provides insight into deeper individual realities, which are closely linked to the participants’ experiences. These are a collection of revealing personal narratives (autobiographical stories) describing how each participant viewed themselves up until the time that the research took place. At its core, this study is primarily a project that explores the use of narrative as a research method. The findings from this research are useful from a practical perspective, as they assist in understanding that the universal forms of stories can be a metaphor for life. It is hoped that the research will enrich the reader, and offer insight into the nature of the founders, and their journeys. From a theoretical point of view, the research will contribute to the knowledge-base by way of the many commercial virtues that may be gained by learning the ways in which successful founders have undergone personal and professional transformations, as they progressed through their journey towards authentic leadership. The autobiographical stories are valuable windows into the emotional and symbolic lives of each founder and their respective organisations. These stories also outline an approach to eliciting and analysing narrative data as part of a complex and multi-faceted study. “Hero’s Journey” is a pattern of narrative described by American scholar Joseph Campbell that has been shown to be present in various forms of storytelling and myths as well as an individual’s psychological development. It explains the typical adventure of the archetype known as The Hero, the person who aims for and achieves significant goals which contribute to the group, tribe, or civilization in a major way. As we are all on our own journey, be it personal or professional with our own set of trials to overcome, it is our own mentors to whom we turn for guidance in search of our own prize. According to Campbell (1949) and Vogler (2007) our seventeen participants are indeed heroes

Mediterranean diet adherence and synergy with acute myocardial infarction and its determinants. a multicenter case-control study in Italy.

Cardiovascular diseases are the leading causes of mortality and morbidity in Western countries. The possible synergistic effect of poor adherence to a Mediterranean diet (MD) and other risk factors for acute myocardial infarction (AMI) such as hypertension, cholesterol, ever smoker, BMI> 25, diabetes, has not been deeply studied. Design Case-control study. Methods Patients with first AMI and controls from four tertiary referral Italian centers were screened for enrolment. Dietary information was collected through a questionnaire and a MD adherence score was calculated. Physical activity and smoking habits were also registered. The Synergy Index was calculated according to Rothman. Results 127 cases and 173 controls were enrolled. The analysis was conducted using a dichotomous variable for the MD score with values 7 representing good adherence. Multivariate analysis showed the following variables associated to AMI: ever smoker (OR = 2.08), diabetes (OR = 1.42), hypertension (OR = 2.08), hypercholesterolemia (OR = 2.47), BMI> 25 (OR = 1.99), while a protective effect emerged both in subjects scoring > 7 on the MD score(OR = 0.55) and in subjects resident of Southern Italy (OR = 0.38). A synergistic effect does exist between poor adherence to the MD and the following risk factors: hypertension, hypercholesterolemia, BMI >25, diabetes and being a resident in central and northern Italy. Conclusion Synergy between heart disease risk factors and MD underlines the need to enlarge the list of known modifiable cardiovascular risk factors to include and promote adherence to Mediterranean dietary habits

Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data

Introduction: In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objective(s): The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods: A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results: The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion: NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes

Healthcare workers training courses on vaccinations: A flexible format easily adaptable to different healthcare settings.

Since 2017, Italy has expanded the compulsory vaccination from 4 to 10 for those aged 0 to 16 years. Because of the great organizational effort required for the immunization services, minor attention was given to the vaccinations not included among the mandatory ones. This situation led to a real difficulty in harmonizing the vaccination procedures even inside a single region. In the Lazio region, the Laboratory of Vaccinology of the University of Rome Tor Vergata established a working group to create a new training model for healthcare professionals. The course program proposed an update of three vaccinations which are not mandatory but actively offered. It included the same part of scientific updating and a variable part based on local experiences. A specific anonymous questionnaire on knowledge and attitude was administered. The study aimed to propose a general format of training courses for vaccination centers adaptable to the individual local health units (ASLs) and to evaluate through questionnaires. The results show differences in knowledge and attitudes toward non‐mandatory vaccinations among the ASLs of Lazio, confirming the usefulness of a support to make knowledge and procedures homogeneous. This model could be adapted to any healthcare setting and exported to other services

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

Aims: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design: Prospective observational study. Methods: Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as \u2018high frequency.\u2019 Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as \u2018high risk.\u2019 The high-frequency/high-risk category of nursing diagnoses was identified. Results: The sample included 2283 patients. A mean of 4\ub75 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion: Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies

Taking screenshots of the invisible: A study on bacterial contamination of mobile phones from university students of healthcare professions in Rome, Italy

Mobile phones (MPs) are commonly used both in the personal and professional life. We assessed microbiological contamination of MPs from 108 students in healthcare professions (HPs), in relation to their demographic characteristics and MPs handling habits, collected by means of a questionnaire. Cultural and biochemical tests were performed, and statistical analyses were carried out. Staphylococci were present in 85% of MPs, Enterococci in 37%, Coliforms in 6.5%; E. coli was never detected. Staphylococcus epidermidis was the most frequently isolated staphylococcal species (72% of MPs), followed by S. capitis (14%), S. saprophyticus, S. warneri, S. xylosus (6%), and by S. aureus (4%). Heterotrophic Plate Counts (HPC) at 37◦C, ranged from 0 to 1.2 × 104 CFU/dm2 (mean = 362 CFU/dm2). In univariate analysis, the male gender only was significantly associated with higher HPCs and enterococcal contamination. Multiple linear regression models explained only 17% and 16% of the HPC 37◦C and staphylococcal load variability, respectively. Developing specific guidelines for a hygienic use of MPs in clinical settings, for preventing cross-infection risks, is advisable, as well as introducing specific training programs to HP students. MPs decontamination procedures could also be implemented in the community

Hydrogeomorphological analysis and modelling for a comprehensive understanding of flash-flood damage processes: the 9 October 2018 event in northeastern Mallorca

[EN] A flash-flood event hit the northeastern part of Mallorca on 9 October 2018, causing 13 casualties. Mal- lorca is prone to catastrophic flash floods acting on a sce- nario of deep landscape transformation caused by Mediter- ranean tourist resorts. As global change may exacerbate dev- astating flash floods, analyses of catastrophic events are cru- cial to support effective prevention and mitigation measures. Field-based remote-sensing and modelling techniques were used in this study to evaluate rainfall¿runoff processes at the catchment scale linked to hydrological modelling. Continu- ous streamflow monitoring data revealed a peak discharge of 442 m³ s¿¹ with an unprecedented runoff response. This ex- ceptional behaviour triggered the natural disaster as a com- bination of heavy rainfall (249 mm in 10 h), karstic features and land cover disturbances in the Begura de Salma River catchment (23 km²). Topography-based connectivity indices and geomorphic change detection were used as rapid post- catastrophe decision-making tools, playing a key role dur- ing the rescue search. These hydrogeomorphological preci- sion techniques were combined with the Copernicus Emer- gency Management Service and ¿ground-based¿ damage as- sessment, which showed very accurately the damage-driving factors in the village of Sant Llorenç des Cardassar. The main challenges in the future are to readapt hydrological modelling to global change scenarios, implement an early flash-flood warning system and take adaptive and resilient measures on the catchment scale.This research was supported by the Spanish Ministry of Science, Innovation and Universities, the Spanish Agency of Research (AEI) and the European Regional Development Fund (ERDF) through the project CGL2017-88200-R "Functional hydrological and sediment connectivity at Mediterranean catchments: global change scenarios -MEDhyCON2".Estrany, J.; Ruiz-Perez, M.; Mutzner, R.; Fortesa, J.; Nacher Rodriguez, B.; Tomas-Burguera, M.; Garcia-Comendador, J.... (2020). Hydrogeomorphological analysis and modelling for a comprehensive understanding of flash-flood damage processes: the 9 October 2018 event in northeastern Mallorca. Natural Hazards and Earth System Sciences. 20(8):2195-2220. https://doi.org/10.5194/nhess-20-2195-2020S21952220208Adamovic, M., Branger, F., Braud, I., and Kralisch, S.: Development of a data-driven semi-distributed hydrological model for regional scale catchments prone to Mediterranean flash floods, J. Hydrol., 541, 173–189, https://doi.org/10.1016/j.jhydrol.2016.03.032, 2016.Agisoft Lens: Agisoft PhotoScan User Manual. Professional Edition, Version 1.4, available at: https://www.agisoft.com/pdf/photoscan-pro_1_4_en.pdf (last access: 12 September 2019), 2018.Ajuntament de Sant Llorenç des Cardassar: Minutes of the Plenary Session of Sant Llorenç des Cardassar City Council, Sant Llorenç des Cardassar, available at: https://ovac.santllorenc.es/absis/idi/arx/idiarxabsaweb/catala/asp/dlgVisor.asp?codigoVerificacion=176102aec9d248aab3b72deaad1e0beb001 (last access: 15 May 2020), 2018.Alfieri, L., Berenguer, M., Knechtl, V., Liechti, K., Sempere-Torres, D., and Zappa, M.: Flash Flood Forecasting Based on Rainfall Thresholds, in Handbook of Hydrometeorological Ensemble Forecasting, edited by: Duan, Q., Pappenberger, F., Wood, A., Cloke, H. L., and Schaake, J. C., 1–38, Springer, 2015.Álvaro, M., Del Olmo, P., and Anglada, E.: Mapa Geológico de España, 1:50 000, Hoja 700 (MANACOR), Madrid, available at: http://info.igme.es/cartografiadigital/datos/magna50/pdfs/d7_G50/Magna50_700.pdf (last access: 30 July 2020), 1991.Amirebrahimi, S., Rajabifard, A., Mendis, P., and Ngo, T.: A framework for a microscale flood damage assessment and visualization for a building using BIM–GIS integration, Int. J. Digit. Earth, 9, 363–386, https://doi.org/10.1080/17538947.2015.1034201, 2016.Amponsah, W., Marchi, L., Zoccatelli, D., Boni, G., Cavalli, M., Comiti, F., Crema, S., Lucía, A., Marra, F., and Borga, M.: Hydrometeorological Characterization of a Flash Flood Associated with Major Geomorphic Effects: Assessment of Peak Discharge Uncertainties and Analysis of the Runoff Response, J. Hydrometeorol., 17, 3063–3077, https://doi.org/10.1175/JHM-D-16-0081.1, 2016.Amponsah, W., Ayral, P.-A., Boudevillain, B., Bouvier, C., Braud, I., Brunet, P., Delrieu, G., Didon-Lescot, J.-F., Gaume, E., Lebouc, L., Marchi, L., Marra, F., Morin, E., Nord, G., Payrastre, O., Zoccatelli, D., and Borga, M.: Integrated high-resolution dataset of high-intensity European and Mediterranean flash floods, Earth Syst. Sci. Data, 10, 1783–1794, https://doi.org/10.5194/essd-10-1783-2018, 2018.Artinyan, E., Vincendon, B., Kroumova, K., Nedkov, N., Tsarev, P., Balabanova, S., and Koshinchanov, G.: Flood forecasting and alert system for Arda River basin, J. Hydrol., 541, 457–470, https://doi.org/10.1016/j.jhydrol.2016.02.059, 2016.Barbosa, S., Silva, Á., and Narciso, P.: Analysis of the 1 November 2015 heavy rainfall episode in Algarve by using weather radar and rain gauge data, Nat. Hazards, 93, 61–76, https://doi.org/10.1007/s11069-017-3065-2, 2018.Barredo, J. I.: Major flood disasters in Europe: 1950–2005, Nat. Hazards, 42, 125–148, https://doi.org/10.1007/s11069-006-9065-2, 2007.BOE: Boletín Oficial del Estado (BOE No. 283) (23/11/2018). Decreto-ley 2/2018, de 18 de octubre, por el que se establecen ayudas y otras medidas urgentes para reparar las pérdidas y los daños producidos por las lluvias intensas y las inundaciones del día 9 de, Spain, available at: https://www.boe.es/boe/dias/2018/11/23/pdfs/BOE-A-2018-15970.pdf (last access: 15 May 2020), 2018.BOE: Boletín Oficial del Estado (BOE, No. 12) (26/01/2019), Real Decreto Ley 2/2019 de 25 de enero, por el que se adoptan medidas urgentes para paliar los daños causados por temporales y otras situaciones catastróficas, Spain, 2019.Borga, M., Boscolo, P., Zanon, F., and Sangati, M.: Hydrometeorological Analysis of the 29 August 2003 Flash Flood in the Eastern Italian Alps, J. Hydrometeorol., 8, 1049–1067, https://doi.org/10.1175/jhm593.1, 2007.Borga, M., Gaume, E., Creutin, J. D., and Marchi, L.: Surveying flash floods: gauging the ungauged extremes, Hydrol. Process., 22, 3883–3885, https://doi.org/10.1002/hyp.7111, 2008.Borselli, L., Cassi, P., and Torri, D.: Prolegomena to sediment and flow connectivity in the landscape: A GIS and field numerical assessment, CATENA, 75, 268–277, https://doi.org/10.1016/j.catena.2008.07.006, 2008.Braud, I., Ayral, P.-A., Bouvier, C., Branger, F., Delrieu, G., Le Coz, J., Nord, G., Vandervaere, J.-P., Anquetin, S., Adamovic, M., Andrieu, J., Batiot, C., Boudevillain, B., Brunet, P., Carreau, J., Confoland, A., Didon-Lescot, J.-F., Domergue, J.-M., Douvinet, J., Dramais, G., Freydier, R., Gérard, S., Huza, J., Leblois, E., Le Bourgeois, O., Le Boursicaud, R., Marchand, P., Martin, P., Nottale, L., Patris, N., Renard, B., Seidel, J.-L., Taupin, J.-D., Vannier, O., Vincendon, B., and Wijbrans, A.: Multi-scale hydrometeorological observation and modelling for flash flood understanding, Hydrol. Earth Syst. Sci., 18, 3733–3761, https://doi.org/10.5194/hess-18-3733-2014, 2014.Calsamiglia, A., García-Comendador, J., Fortesa, J., López-Tarazón, J. A., Crema, S., Cavalli, M., Calvo-Cases, A., and Estrany, J.: Effects of agricultural drainage systems on sediment connectivity in a small Mediterranean lowland catchment, Geomorphology, 318, 162–171, https://doi.org/10.1016/j.geomorph.2018.06.011, 2018.Calvo-Cases, A., Gago, J., Ruiz-Pérez, M., García-Comendador, J., Fortesa, J., Company, J., Nácher-Rodríguez, B., Vallés-Morán, F. J., and Estrany, J.: Spatial distribution of geomorphic changes after an extreme flash-flood compared with hydrological and sediment connectivity, in European Geosciences Uninon General Assembly 2020, Copernicus Publications, 2020.Cassola, F., Ferrari, F., Mazzino, A., and Miglietta, M. M.: The role of the sea on the flash floods events over Liguria (northwestern Italy), Geophys. Res. Lett., 43, 3534–3542, https://doi.org/10.1002/2016GL068265, 2016.Cavalli, M., Trevisani, S., Comiti, F., and Marchi, L.: Geomorphometric assessment of spatial sediment connectivity in small Alpine catchments, Geomorphology, 188, 31–41, https://doi.org/10.1016/j.geomorph.2012.05.007, 2013.CCS: Estudio Siniestralidades 2018, Inundación extraordinaria Mallorca: Sant Llorenç des Cardassar. Consorcio de Compensación de Seguros. Ministerio de Economía y Empresa. Gobierno de España, available at: https://www.consorseguros.es/web/inicio (last access: 15 May 2020), 2018.Chapon, B., Delrieu, G., Gosset, M., and Boudevillain, B.: Variability of rain drop size distribution and its effect on the Z–R relationship: A case study for intense Mediterranean rainfall, Atmos. Res., 87, 52–65, https://doi.org/10.1016/j.atmosres.2007.07.003, 2008.Collier, C. G.: Flash flood forecasting: What are the limits of predictability?, Q. J. Roy. Meteor. Soc., 133, 3–23, https://doi.org/10.1002/qj.29, 2007.Copernicus Emergency Management Service: [EMSR323] Flood in Balearic Island, Spain, available at: https://emergency.copernicus.eu/mapping/list-of-components/EMSR323 (last access: 15 May 2020), 2018.Copernicus Emergency Management Service: Directorate Space, Security and Migration, European Commission Joint Research Centre, available at: https://emergency.copernicus.eu/ (last access: 14 August 2019), 2019.Corine Land Cover: Copernicus Land Monitoring Service, available at: https://land.copernicus.eu/pan-european/corine-land-cover/clc2018 (last access: 15 May 2020), 2018.Crema, S. and Cavalli, M.: SedInConnect: a stand-alone, free and open source tool for the assessment of sediment connectivity, Comput. Geosci., 111, 39–45, https://doi.org/10.1016/j.cageo.2017.10.009, 2018.Defossez, S. and Leone, F.: Assessing Vulnerability to Flooding: Progress and Limitations, Floods, 241–257, https://doi.org/10.1016/B978-1-78548-268-7.50014-6, 2017.Duo, E., Trembanis, A. C., Dohner, S., Grottoli, E., and Ciavola, P.: Local-scale post-event assessments with GPS and UAV-based quick-response surveys: a pilot case from the Emilia–Romagna (Italy) coast, Nat. Hazards Earth Syst. Sci., 18, 2969–2989, https://doi.org/10.5194/nhess-18-2969-2018, 2018.ESRI: Arc Hydro Tools, available at: https://www.esri.com/en-us/home (last access: 15 May 2020), 2019.Estrany, J. and Grimalt, M.: Catchment controls and human disturbances on the geomorphology of small Mediterranean estuarine systems, Estuar. Coast. Shelf Sci., 150, 1–12, https://doi.org/10.1016/j.ecss.2014.03.021, 2014.Estrany, J., Garcia, C., and Batalla, R. J.: Groundwater control on the suspended sediment load in the Na Borges River, Mallorca, Spain, Geomorphology, 106, 292–303, https://doi.org/10.1016/J.GEOMORPH.2008.11.008, 2009.Estrany, J., Ruiz, M., Calsamiglia, A., Carriquí, M., García-Comendador, J., Nadal, M., Fortesa, J., López-Tarazón, J. A., Medrano, H., and Gago, J.: Sediment connectivity linked to vegetation using UAVs: High-resolution imagery for ecosystem management, Sci. Total Environ., 671, 1192–1205, https://doi.org/10.1016/j.scitotenv.2019.03.399, 2019.Estrany, J., Ruiz-Pérez, M., Mutzner, R., Fortesa, J., Nácher-Rodríguez, B., Tomàs-Burguera, M., García-Comendador, J., Peña, X., Calvo-Cases, A., and Vallés-Morán, F. J.: Discharge data series of Begura de Salma River (Mallorca, Spain): January 2015–October 2018, PANGAEA, https://doi.org/10.1594/PANGAEA.921411 2020a.Estrany, J., Ruiz-Pérez, M., Mutzner, R., Fortesa, J., Nácher-Rodríguez, B., Tomàs-Burguera, M., García-Comendador, J., Peña, X., Calvo-Cases, A., and Vallés-Morán, F. J.: Monthly precipitation and runoff series of Begura de Salma River (Mallorca, Spain): January 2015–October 2018, PANGAEA, https://doi.org/10.1594/PANGAEA.921412, 2020b.Fortesa, J., García-Comendador, J., Calsamiglia, A., López-Tarazón, J. A., Latron, J., Alorda, B., and Estrany, J.: Comparison of stage/discharge rating curves derived from different recording systems: Consequences for streamflow data and water management in a Mediterranean island, Sci. Total Environ., 665, 968–981, https://doi.org/10.1016/j.scitotenv.2019.02.158, 2019.Fulton, R. A., Breidenbach, J. P., Seo, D.-J., Miller, D. A., and O'Bannon, T.: The WSR-88D Rainfall Algorithm, https://doi.org/10.1175/1520-0434(1998)013<0377:TWRA>2.0.CO;2, 1998.García-Hernández, J., Jordan, J., Dubois, J., Boillat, J., and Schleiss, A.: Routing System II: Flow modelling in hydraulic systems, Communication, 32, 1661–1179, 2007.Gaume, E., Bain, V., Bernardara, P., Newinger, O., Barbuc, M., Bateman, A., Blaškovičová, L., Blöschl, G., Borga, M., Dumitrescu, A., Daliakopoulos, I., Garcia, J., Irimescu, A., Kohnova, S., Koutroulis, A., Marchi, L., Matreata, S., Medina, V., Preciso, E., Sempere-Torres, D., Stancalie, G., Szolgay, J., Tsanis, I., Velasco, D., and Viglione, A.: A compilation of data on European flash floods, J. Hydrol., 367, 70–78, https://doi.org/10.1016/J.JHYDROL.2008.12.028, 2009.Gaume, E., Borga, M., Llasat, M. C., Maouche, S., Lang, M., and Diakakis, M.: Mediterranean extreme floods and flash floods, in The Mediterranean Region under Climate Change. A Scientific Update, edited by: French National Alliance for Environmental Research – ALLENVI, 133–144, available at: https://hal.archives-ouvertes.fr/hal-01465740v2/document (last access: 15 May 2020), 2016.Georgakakos, K. P.: On the Design of National, Real-Time Warning Systems with Capability for Site-Specific, Flash-Flood Forecasts, B. Am. Meteorol. Soc., 67, 1233–1239, https://doi.org/10.1175/1520-0477(1986)067<1233:OTDONR>2.0.CO;2, 1986.Germann, U. and Joss, J.: Operational Measurement of Precipitation in Mountainous Terrain, Springer, Berlin, Heidelberg, 52–77, 2004.GOIB: Mapas de peligrosidad y riesgo de inundación en la demarcación hidrográfica de Baleares. Conselleria de Medi Ambient, Agricultura i Pesca-Direcció General de Recursos Hídrics, available at: https://www.caib.es/sites/aigua/es/plan_de_ gestion_ del_riesgo_ de_ inundacion_de_ la_ demarcacion_hidrografica_ de_ las_islas_ baleares/ (last access: 15 May 2020), 2016.GOIB: Boletín Oficial de las Islas Baleares (BOIB No. 130) (18/10/2018), Decreto-ley 2/2018, de 18 de octubre, por el que se establecen ayudas y otras medidas urgentes para reparar las pérdidas y los daños producidos por las lluvias intensas y las inundaciones, available at: http://www.caib.es/eboibfront/pdf/ca/2018/130/101958 (last access: 15 May 2020), 2018.GOIB: El Govern ja ha abonat 30,4 milions d'euros en ajuts i actuacions de preparació de danys produïts per les inundacions del Llevant, English version: The Balearic Government has already paid 30.4 million euros in aid and actions for the damage caused by the floods in the Llevant county, available at: https://www.caib.es/pidip2front/jsp/ca/fitxa-convocatoria/strongel-govern-ja-ha-abonat-304-milions-drsquoeuros-en-ajuts-i-actuacions-de-reparacioacute-de-danys-produiumlts-per-les-inundacions-del-llevantstrongnbsp (last access: 15 May 2020), 2019.Gourley, J. J., Giangrande, S. E., Hong, Y., Flamig, Z. L., Schuur, T., and Vrugt, J. A.: Impacts of Polarimetric Radar Observations on Hydrologic Simulation, J. Hydrometeorol., 11, 781–796, https://doi.org/10.1175/2010JHM1218.1, 2010.Guijarro, J. A.: Contribución a la Bioclimatología de Baleares, Universitat de les Illes Balears, PhD thesis, available at: http://hdl.handle.net/20.500.11765/5369 (last access: 30 July 2020), 1986.Hardy, J., Gourley, J., Kirstetter, P., Hong, Y., Kong, F., and Flamig, Z.: A method for probabilistic flash flood forecasting, J. Hydrol., 541, 480–494 2016.Harrison, D., Driscoll, S., and Kitchen, M.: Improving precipitation estimates from weather radar using quality control and correction techniques, Meteorol. Appl., 7, 135–144, https://doi.org/https://doi.org/10.1017/S1350482700001468, 2000.Instituto Geográfico Nacional: Digital Terrain Model for Spain obtained from lidar flights, available at: http://centrodedescargas.cnig.es/CentroDescargas/locale?request_locale=en (last access: 15 May 2020), 2014.Jordan, F.: Modèle de prévision et de gestion des crues-optimisation des opérations des aménagements hydroélectriques à accumulation pour la réduction des débits de crue, Laboratory of Hydraulic Construction, Ecole Polytechnique Fédérale de Lausanne, Lausanne, 2007.Kalantari, Z., Cavalli, M., Cantone, C., Crema, S., and Destouni, G.: Flood probability quantification for road infrastructure: Data-driven spatial-statistical approach and case study applications, Sci. Total Environ., 581–582, 386–398, https://doi.org/10.1016/J.SCITOTENV.2016.12.147, 2017.Langhammer, J. and Vacková, T.: Detection and Mapping of the Geomorphic Effects of Flooding Using UAV Photogrammetry, Pure Appl. Geophys., 175, 3223–3245, https://doi.org/10.1007/s00024-018-1874-1, 2018.Laudan, J., Rözer, V., Sieg, T., Vogel, K., and Thieken, A. H.: Damage assessment in Braunsbach 2016: data collection and analysis for an improved understanding of damaging processes during flash floods, Nat. Hazards Earth Syst. Sci., 17, 2163–2179, https://doi.org/10.5194/nhess-17-2163-2017, 2017.Li, Z., Xu, X., Zhu, J., Xu, C., and Wang, K.: Effects of lithology and geomorphology on sediment yield in karst mountainous catchments, Geomorphology, 343, 119–128, https://doi.org/10.1016/j.geomorph.2019.07.001, 2019.Llasat, M. C., Llasat-Botija, M., Petrucci, O., Pasqua, A. A., Rosselló, J., Vinet, F., and Boissier, L.: Towards a database on societal impact of Mediterranean floods within the framework of the HYMEX project, Nat. Hazards Earth Syst. Sci., 13, 1337–1350, https://doi.org/10.5194/nhess-13-1337-2013, 2013.Lorenzo-Lacruz, J., Amengual, A., Garcia, C., Morán-Tejeda, E., Homar, V., Maimó-Far, A., Hermoso, A., Ramis, C., and Romero, R.: Hydro-meteorological reconstruction and geomorphological impact assessment of the October 2018 catastrophic flash flood at Sant Llorenç, Mallorca (Spain), Nat. Hazards Earth Syst. Sci., 19, 2597–2617, https://doi.org/10.5194/nhess-19-2597-2019, 2019.Lowe, D.: Distinctive Image Features from Scale-Invariant Keypoints, Vancouver, available at: https://robo.fish/wiki/images/5/58/Image_Features_ From_ Scale_Invariant_ Keypoints_ Lowe_2004.pdf (last access: 11 September 2019), 2004.Marchi, L., Borga, M., Preciso, E., and Gaume, E.: Characterisation of selected extreme flash floods in Europe and implications for flood risk management, J. Hydrol., 394, 118–133, https://doi.org/10.1016/j.jhydrol.2010.07.017, 2010.Marshall, J. S. and Palmer, W. M. K.: The distribution of raindrops with size, J. Meteorol., 5, 165–166, https://doi.org/10.1175/1520-0469(1948)005<0165:TDORWS>2.0.CO;2, 1948.Merheb, M., Moussa, R., Abdallah, C., Colin, F., Perrin, C., and Baghdadi, N.: Hydrological response characteristics of Mediterranean catchments at different time scales: a meta-analysis, Hydrolog. Sci. J., 61, 2520–2539, https://doi.org/10.1080/02626667.2016.1140174, 2016.Miao, Q., Yang, D., Yang, H., and Li, Z.: Establishing a rainfall threshold for flash flood warnings in China's mountainous areas based on a distributed hydrological model, J. Hydrol., 541, 371–386, https://doi.org/10.1016/j.jhydrol.2016.04.054, 2016.Nguyen, P., Thorstensen, A., Sorooshian, S., Hsu, K., AghaKouchak, A., Sanders, B., Koren, V., Cui, Z., and Smith, M.: A high resolution coupled hydrologic–hydraulic model (HiResFlood-UCI) for flash flood modeling, J. Hydrol., 541, 401–420, https://doi.org/10.1016/j.jhydrol.2015.10.047, 2016.Petrus, J. M., Ruiz, M., and Estrany, J.: Interactions between Geomorphology and Urban Evolution since Neolithic Times in a Mediterranean City, in: Urban Geomorphology, Landforms and Processes in Cities, edited by: Thornbush, M. J. and Allen, C. D., 9–35, https://doi.org/10.1016/B978-0-12-811951-8.00002-3, 2018.Piaggesi, D., Sund, K. J., and Castelnovo, W.: Global strategy and practice of e-governance?: examples from around the world, Information Science Reference, available at: https://www.igi-global.com/book/global-strategy-practice-governance/46168 (last access: 30 July 2020), 2011.Plank, S.: Rapid Damage Assessment by Means of Multi-Temporal SAR – A Comprehensive Review and Outlook to Sentinel-1, Remote Sens., 6, 4870–4906, https://doi.org/10.3390/rs6064870, 2014.PNOA: Plan Nacional de Ortofotografía Aérea, Instituto Geográfico Nacional, Ministerio de Fomento, Gobierno de España, available at: https://pnoa.ign.es/productos_lidar (last access: 15 May 2020), 2015.Pol, J.: Informe INUNBAL Llevant Mallorca 2018, ISO 271/2018, available at: http://www.caib.es/pidip2front/jsp/adjunto?codi=2243620&idioma=ca (last access: 30 July 2020), Marratxí, 2019a.Pol, J.: Predicción y Gestión de Emergencias por Inundaciones, in: International Seminar of Planning and Management of Flood Risks in Mediterranean Environments, INAGEA, University of the Balearic Islands, Palma, 2019b.Pons Esteva, A.: Evolució dels usos del sòl a les illes Balears, 1956–2000, Territoris, 4, 129–145, 2003.Schaefli, B., Hingray, B., Niggli, M., and Musy, A.: A conceptual glacio-hydrological model for high mountainous catchments, Hydrol. Earth Syst. Sci., 9, 95–109, https://doi.org/10.5194/hess-9-95-2005, 2005.Segura-Beltrán, F., Sanchis-Ibor, C., Morales-Hernández, M., González-Sanchis, M., Bussi, G., and Ortiz, E.: Using post-flood surveys and geomorphologic mapping to evaluate hydrological and hydraulic models: The flash flood of the Girona River (Spain) in 2007, J. Hydrol., 541, 310–329, https://doi.org/10.1016/J.JHYDROL.2016.04.039, 2016.Seo, B. C., Krajewski, W. F., and Qi, Y.: Utility of Vertically Integrated Liquid Water Content for Radar-Rainfall Estimation: Quality Control and Precipitation Type Classification, Atmos. Res., 236, 104800, https

Microbiology and Clinical Outcome of Hospital-Acquired Respiratory Infections in an Italian Teaching Hospital: A Retrospective Study

The burden, microbial etiology and clinical impact of hospital-acquired respiratory infections (HARIs) were determined at an Italian teaching hospital over a 12-month period. For this purpose, overall ordinary hospitalizations >= 2 days of subjects over 18 years old with discharge from 1 January 2018 to 31 December 2018 were examined by cross-referencing demographic and clinical data from hospital discharge forms with microbiological data from the computer system of the Microbiology Unit. We identified 329 individuals with HARIs (96 females and 233 males; median age 70 years, range 18-93), who represented 1/4 of the total hospital-acquired infections (HAIs) in the period. The inpatient setting was medical and surgical in similar proportions (169 vs. 160, respectively) and the mean hospital stay was 38.9 +/- 33.6 days. One hundred and forty patients (42.6% of the total sample) were suffering from one or more chronic diseases. A total of 581 microorganisms (82 antibiotic-resistant and 499 non-resistant) were detected in HARI patients. The most common isolated species were Staphylococcus aureus (16.7%), Klebsiella pneumoniae (13.3%), Pseudomonas spp. (12.6%) and Acinetobacter baumannii (10.5%), followed by Enterobacter spp. (5.3%), Escherichia coli (5.2%) and Enterococcus spp. (4.8%). One hundred and sixty-seven individuals (49.0% of the total) had polymicrobial infections. One hundred thirty-one patients (39.8% of the total) underwent endotracheal intubation and mechanical ventilation and 62.6% of them died, compared to 17.7% of the non-intubated patients. Multivariable analysis confirmed a positive correlation between death and increased age (p = 0.05), surgical MDC (p = 0.007), number of microorganisms over the sample mean (p = 0.001), the presence of chronic diseases (p = 0.046), and intubation and mechanical ventilation (p < 0.0001). A positive correlation between intubation and antibiotic-resistant organisms (p = 0.003) was also found. HARIs are still a major public health problem and require constant surveillance due to their severe clinical outcome

Predictive Value of MR-proADM in the Risk Stratification and in the Adequate Care Setting of COVID-19 Patients Assessed at the Triage of the Emergency Department

In the past two pandemic years, Emergency Departments (ED) have been overrun with COVID-19-suspicious patients. Some data on the role played by laboratory biomarkers in the early risk stratification of COVID-19 patients have been recently published. The aim of this study is to assess the potential role of the new biomarker mid-regional proadrenomedullin (MR-proADM) in stratifying the in-hospital mortality risk of COVID-19 patients at the triage. A further goal of the present study is to evaluate whether MR-proADM together with other biochemical markers could play a key role in assessing the correct care level of these patients. Data from 321 consecutive patients admitted to the triage of the ED with a COVID-19 infection were analyzed. Epidemiological; demographic; clinical; laboratory; and outcome data were assessed. All the biomarkers analyzed showed an important role in predicting mortality. In particular, an increase of MR-proADM level at ED admission was independently associated with a threefold higher risk of IMV. MR-proADM showed greater ROC curves and AUC when compared to other laboratory biomarkers for the primary endpoint such as in-hospital mortality, except for CRP. This study shows that MR-proADM seems to be particularly effective for early predicting mortality and the need of ventilation in COVID-19 patients admitted to the ED

Lohengrin

Director : Georges SebastianFunció a benefici dels empleats permanents, porters i acomodadors del G.T. del LiceuMestre de cor : José Anglada ; Decorats : M. Vilomara i J. Mestres CabanesÒpera en tres actes, dividits en quatre quadres, llibret i música de Richard Wagne