A multicenter study on the appropriateness of hospitalization in obstetric wards: application of Obstetric Appropriateness Evaluation Protocol (Obstetric AEP)

The cross-sectional study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) in seven hospitals to determine inappropriate hospital admissions and days of stay. The outcomes were: inappropriateness of admission and "percentage of inappropriateness" for one hospitalization. A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for hospitalization was 22%. The percentage of inappropriateness for the first 10 d of hospitalization peaked in correspondence of the fourth (42%). The logistic regression model on inappropriated admission reported that emergency admission was a protective factor (OR = 0.4) and to be hospitalized in wards with 6530 beds risk factor (OR = 5.12). The second linear model on "percentage of inappropriateness" showed that inappropriated admission and wards with 6530 beds increased the percentage (p < 0.001); whereas the admission in Teaching Hospitals was inversely associated (p < 0.001). The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This probably indicates that management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The OAEP tool seems to be an useful instrument for the decision-makers to monitor and manage the obstetric wards. \ua9 2014 Informa UK Ltd. All rights reserved

Appropriateness of admission and days of stay in pediatric hospital in Ancona, Italy

Background: In Italy, hospital admission costs account for nearly 42% of total health expenditure; in the Marche region, this share exceeds 50%. High costs of hospitalization, however, can be partly explained by inappropriate use. The aim of this research was to assess the risk factors associated with inappropriate hospital admissions and stay for acute pediatric patients. Methods: Clinical records of children from 30 days to 14 years of age admitted to the wards of orthopedics, pediatrics, pediatric isolation, pediatric surgery and pediatric oncohematology at Salesi Pediatric Hospital of Ancona throughout 2004 were reviewed. The Italian Pediatric Appropriateness Evaluation Protocol (PRUO) was used as a tool for assessing inappropriateness of admission and days of stay. Results: Overall 21.7% (95% CI = 16.1%–22.4%) of hospital admissions and 30.3% (95% CI = 26.0%–34.9%) of days of stay were judged to be inappropriate. Multiple logistic regression analysis indicated that inappropriate admission was significantly associated with type of admission, discharge ward and place of residence. Inappropriateness of stay was significantly higher if admission was to a medical ward and if admission itself was judged inappropriate. Conclusions: In a socioeconomic context in which reducing waste is necessary, ineffective health care interventions are no longer tolerable. As a tool capable of integrating each patient’s specific features with those of the health care process, the pediatric PRUO could be a valid tool in the hands of managers for monitoring the appropriateness of admission and stay

Исследовательская деятельность эколого-биологической направленности в НОУ "Эврика" - эффективное средство профессиональной ориентации учащихся

В статье научно-исследовательская деятельность эколого-биологической направленности старшеклассников НОУ "Эврика" г. Нижнего Новгорода рассматривается как одна из значимых инновационных форм профессионального самоопределения. Материалом исследования послужил анализ программ конференции городского научного общества учащихся "Эврика" и судьбы выпускников данного общества. Отмечена тенденция роста популярности эколого-биологических исследований среди старшеклассников г. Нижнего Новгорода и успешное вхождение в профессию выпускников научного общества учащихся.In the article, the research activity of the ecology and biology of senior pupils of the scientific society of the pupils "Eureka" in Nizhny Novgorod is considered as one of the significant innovative forms of professional self-determination. The material of the study was the analysis of the programs of the conference of the city scientific society of the students "Eureka" and the fate of the graduates of this society. The tendency of growth of popularity of ecological and biological researches among senior pupils of Nizhny Novgorod and successful entry into the profession of graduates of the scientific society of students is noted

Surface Deposition and Imaging of Large Ag Clusters Formed in He Droplets

The utility of a continuous beam of He droplets for the assembly and surface deposition of Ag clusters, ~ 300 - 6 000, is studied with transmission electron microscopy. Images of the clusters on amorphous carbon substrates obtained at short deposition times have provided for a measure of the size distribution of the metal clusters. The average sizes of the deposited clusters are in good agreement with an energy balance based estimate of Ag cluster growth in He droplets. Measurements of the deposition rate indicate that upon impact with the surface the He-embedded cluster is attached with high probability. The stability of the deposited clusters on the substrate is discussed.Comment: 24 pages, 5 figure

Adherence issues related to sublingual immunotherapy as perceived by allergists

Objectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers. © 2010 Scurati et al, publisher and licensee Dove Medical Press Ltd

Applicazione delle anulazioni di cemento per la determinazione dell'et\ue0 di resti umani

Scopo di tale lavoro \ue8 verificare l'applicabilit\ue0, l'accuratezza e la precisione di tre differenti metodi per la valutazione dell'et\ue0 biologica: il conteggio delle anulazioni del cemento radicolare, il metodo di Lamendin e quello di Gustafson-Johanson. Per il metodo delle anulazioni del cemento sono stati utilizzati 194 denti decalcificati e non, colorati istologicamente mediante Ematossilina-Eosina, von Kossa e Tricromica di Masson; tale metodo risulta essere quello con il maggior coefficiente di correlazione ed ha inoltre restituito una maggiore precisione, mentre a suo sfavore gioca un tempo di preparazione dei campioni piuttosto lungo. Il metodo \ue8 stato testato anche su materile di natura archeologica. Sia il metodo di Lamendin che il Gustafson-Johanson, tendono a sovrastimare l'et\ue0 entro i 40 anni ed a sottostimarla al di sopra dei 40, ed entrambi i metodi si dimostrano pi\uf9 accurati in un range d'et\ue0 compreso tra i 35 ed i 45 anni, quello di Gustafson-Johanson \ue8 leggermente pi\uf9 preciso, mentre il Lamendin \ue8 certamente pi\uf9 semplice da applicare per i non esperti

AGING BY CEMENTUM ANNULATION: SEARCHING FOR A PROPER PROTOCOL AND TESTING ITS REABILITY ON AN ITALIAN MODERN POPULATION

Age estimation is a crucial point in the reconstruction af biological profile. Teeth are a fundamental biological age indicator. The poster describe the LabAnOF experience in dental age estimation based on cementum annulation

Decomposizione in diversi ambienti : analisi macroscopiche e microscopiche delle alterazioni post-mortali on modelli animali

Introduzione:Gli studi osservazionali delle fasi di decomposizione del cadavere eseguiti in differenti ambienti, rappresentano un utile mezzo per l\u2019indagine medico-legale che consente di ottenere informazioni sulla inter-relazione tra le caratteristiche ambientali, la permanenza di un corpo in una specifica zona e le alterazioni tafonomiche. E\u2019 possibile, in tal modo, analizzare lo sviluppo di specifici quadri di decomposizione in diverse condizioni ambientali soprattutto in quelle che, di rado, sono oggetto di indagine sperimentale. Scopo del presente lavoro \ue8 lo studio macroscopico e microscopico dei fenomeni di decomposizione e tanatologici subiti da campioni animali lasciati a decomporsi sperimentalmente in diversi ambienti. Materiali e metodi: Gli ambienti analizzati sono stati: aria aperta, sacchi di plastica, acqua dolce e cemento e come modelli di decomposizione sono stati utilizzati 8 maiali (Linneus Scrofa) deceduti per cause indipendenti dallo studio. Di questi, uno presentava lesioni termiche (bruciature) prodotte sperimentalmente nel periodo post-mortem. Nel caso studiato all\u2019aria aperta e nei sacchi di plastica sono stati effettuati rilievi sia macroscopici che istologici ogni 6 giorni per un totale di 7 settimane. Nel caso studiato nell\u2019acqua dolce i campionamenti sono stati eseguiti ad un intervallo di tempo di 5, 10 e 15 settimane mentre, nel caso studiato nel cemento all\u2019intervallo di 4, 9, 14, e 30 settimane. Risultati: I risultati macroscopici hanno evidenziato come i processi di decomposizione siano pi\uf9 rapidi nei campioni bruciati rispetto a quelli decomposti all\u2019aria aperta, mentre risultino pi\uf9 rallentati nei campioni immersi in acqua dolce. Una maggiore conservazione dei tessuti si \ue8 registrata nei campioni inclusi in cemento. Inoltre, al contrario di quanto atteso dai dati della letteratura specifica, la decomposizione nel sacco di plastica \ue8 risultata essere molto rapida. I risultati istologici hanno mostrato, nel caso dei campioni bruciati, scarse alterazioni riferibili al periodo di putrefazione e grossolane alterazioni dovute all\u2019azione termica esercitata. Nel caso dei campioni immersi in acqua dolce, le prime alterazioni putrefattive della cute sono apparse dopo 10 settimane di degradazione sperimentale; nel cemento dopo 4 settimane a carico di epitelio, derma e tessuto adiposo e, dopo 9 settimane, a carico del tessuto muscolare. Nel caso dei campioni decomposti all\u2019aria aperta le prime alterazioni sono apparse dopo 2 settimane ed infine, nei maiali posti in sacco di plastica, dopo 1 settimana con alterazioni a carico del tessuto adiposo e muscolare e, dopo 2 settimane, a carico del derma. Conclusioni: Lo studio pilota presentato evidenzia una stretta dipendenza del processo putrefattivo post-mortale dall\u2019ambiente esterno con alcune variabili che riguardano condizioni estreme di degradazione quali ad esempio il sacco di plastica o il cemento. I risultati preliminari necessitano di ulteriori casi da valutare al fine di studiare il processo di decomposizione nei differenti ambienti naturali o artificiali