The Niguarda MEWS, a new and refined tool to determine criticality and instability in Internal Medicine Ward and Emergency Medicine Unit

This study compares the effect of the modified early warning score (MEWS) versus a new early warning system (Niguarda MEWS) for detecting instability and criticality in hospital medical departments. A retrospective observational study was conducted in the Internal Medicine ward of Niguarda Ca' Granda Hospital in Milan between November 2013 and October 2014. MEWS and Niguarda-MEWS were gathered using: systolic blood pressure, respiratory frequency, heart rate, temperature, level of consciousness, oxygen saturation, creatinine level, hematocrit level and age. In order to determine if the patient was critical or not the MEWS criticality cut-off value chosen was 3, while in the Niguarda MEWS it was 6. The primary outcome was the correlation between the critical level of the two scores and in-hospital mortality. The secondary endpoint was the correlation between a specific disease and the two scores. In the study, 471 patients were included, using both the MEWS and the Niguarda MEWS score at admittance: 33.4% of patients turned out to be critically ill using the former, 40.98% when using the latter. Therefore, the specificity of scores was 70% for MEWS and 73% for Niguarda MEWS, the sensitivity 58% for MEWS and 63% for Niguarda MEWS, Niguarda MEWS area under the curve (AUC): 0.736, MEWS AUC: 0.670. For the secondary outcome, the new score is higher for genitourinary and respiratory diseases. Niguarda-MEWS could be an optimal tool to detect criticality and instability in order to address the patient to the right level of care

The evolving landscape in the management of gastric metastases from melanoma: a case series

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Quale teoria del significato in psicologico clinica.

Il lavoro discute le concezioni del significato sottese alle diverse teorie clinich

Marsico, G., Andrisano Ruggieri, R. & Salvatore, S. (Eds). (2015). Reflexivity and Psychology. Yearbook of Idiographic Science Volume 6. Charlotte, NC, USA.: Information Age Publishing;

Reflexivity is a category that is too appealing not to arouse interest. It is a concept largely diffused in several psychological domains, as well as associated with epistemological, theoretical, methodological and practical discussions. At the same time, it is a very polysemic notion, understood and used in many different ways. If one approaches the notion and tries to identify the semantic boundaries of its usage, the seeming solidity of the term fades away, and a rather liquid semantic field emerges – a field where several interpretations coexist, being contingent to the context of the discussion in which they are implemented. This is the reason that makes the notion of reflexivity a prototypical example of the difficulties encountered by Psychology – and more in general social sciences –in the effort to define their own language. The term “reflexivity” - like many others the language of Psychology is full of – is used in daily life and thus its semantics is shaped by the pragmatic, contingent functions it serves in such communicational circumstances. The apparent – from afar - clearness of the concept does not concern its conceptual, epistemic status, but the capacity of the sign to contribute efficaciously to mediate and regulate the exchange. The theoretical elaboration of the notion of reflexivity can be seen as one of the ways of performing the challenging task of developing an intentional language for Psychology. By working on such a notion one can realize that common sense lies at the core of psychological science and what it means to separate the former from the latter, so as to pursue the foundational task of developing Psychology as a theory-driven science

Salvatore, S., Marsico, G. & Ruggieri Andrisano, R., (2015). Psychology of reflexivity and reflexivity for psychology. In G., Marsico, R., Andrisano Ruggieri, & S., Salvatore, (Eds). (2015). Reflexivity and Psychology. Yearbook of Idiographic Science Volume 6. (pp. vii-xxi), Charlotte, NC, USA.: Information Age Publishing

by Information Age Publishing All rights of reproduction in any form reserved. vii Editorial Introduction Psychology of Reflexivity and Reflexivity for Psychology The Yearbook of Idiographic Science Series (YIS) has been promoting a rethinking of psychological science in idiographic terms. In so doing, it has tried to reconsider the way this notion is understood. Idiographic science is not a science that negates the purpose of general knowledge, but pursues general knowledge through the particularity of events (Salvatore, 2014,2015; Salvatore & Valsiner, 2009, 2010, 2011; Valsiner & Salvatore, 2012; Valsiner, Salvatore, Gennaro, & Traves Simon, 2010). A long tradition has produced a misleading interpretation of the categories of idiographic and nomothetic. Such an interpretation has hindered the development of psychology and more in general of social science. “Idiographic” has been treated as a matter of identity, an ideological approach that continues to be reproduced through the conflict with what-is-outside-it (i.e., nomothetic mainstream psychology). Far from such a militant ritualization of the concept, YIS aims at promoting a return to the origin of what Windelband (1904/1998) proposed, namely the idea of idiographic and nomothetic as categories depicting two complementary—rather than alternative - forms of knowledge building

"In vitro" fibril formation of type I collagen from different sources: biochemical and morphological aspects.

Acid soluble type I collagen was prepared from foetal and adult bovine tendon and skin and from adult bovine cornea. The degree of hydroxylysine glycosylation and the hydroxylysine di-to monoglycoside ratio as well as the "in vivo" fibril diameters, were shown to be tissue and age-dependent. Fibrils of type I collagens were reconstituted "in vitro" monitoring at 313 nm. The fibrils obtained were examined by electron microscopy. It was shown that the "in vitro" lateral growth of collagen fibrils leads to the formation of fibrils with maximum diameters which may be correlated to those of the corresponding native fibrils. Moreover it is suggested that one of the factors controlling the lateral growth of collagen may be at the level of hydroxylysine glycosylation

The Niguarda MEWS, a new and refined tool to determine criticality and instability in Internal Medicine Ward and Emergency Medicine Unit

This study compares the effect of the modified early warning score (MEWS) versus a new early warning system (Niguarda MEWS) for detecting instability and criticality in hospital medical departments. A retrospective observational study was conducted in the Internal Medicine ward of Niguarda Ca’ Granda Hospital in Milan between November 2013 and October 2014. MEWS and Niguarda-MEWS were gathered using: systolic blood pressure, respiratory frequency, heart rate, temperature, level of consciousness, oxygen saturation, creatinine level, hematocrit level and age. In order to determine if the patient was critical or not the MEWS criticality cut-off value chosen was 3, while in the Niguarda MEWS it was 6. The primary outcome was the correlation between the critical level of the two scores and in-hospital mortality. The secondary endpoint was the correlation between a specific disease and the two scores. In the study, 471 patients were included, using both the MEWS and the Niguarda MEWS score at admittance: 33.4% of patients turned out to be critically ill using the former, 40.98% when using the latter. Therefore, the specificity of scores was 70% for MEWS and 73% for Niguarda MEWS, the sensitivity 58% for MEWS and 63% for Niguarda MEWS, Niguarda MEWS area under the curve (AUC): 0.736, MEWS AUC: 0.670. For the secondary outcome, the new score is higher for genitourinary and respiratory diseases. Niguarda-MEWS could be an optimal tool to detect criticality and instability in order to address the patient to the right level of care

Understanding the relationship between Sentinel Events and Sources of Work Related Stress for prevention programs. An Italian survey.

Understanding the relationship between Sentinel Events and Sources of Work Related Stress for prevention programs. An Italian survey

Per un quadro dello stragismo nazista e fascista nelle Marche (settembre 1943-settembre 1944)

l volume presenta gli Atti dell'omonimo Convegno, aperto a Pietralunga il 14 maggio 2015, proseguito e concluso a Fabriano il giorno successivo. Esso conclude idealmente il percorso intrapreso dall'Istituto per la storia dell'Umbria contemporanea (Isuc) e dall'Istituto regionale per la storia del movimento di Liberazione nelle Marche (Irsmlm) a partire dal 2011, inteso a promuovere in comune lo studio e la produzione storiografica sugli anni della Seconda guerra mondiale e della Resistenza, concentrando l'attenzione non sui due territori regionali generalmente intesi, ma sulla fascia appenninica che ne delimita il confine. Le suddette giornate di studio miravano a completare il percorso indicato, in concomitanza con la fase culminante del triennio 2013-2015, dedicato alle celebrazioni del 70° anniversario della Resistenza e Liberazione dal nazifascismo, proponendo i risultati acquisiti sui più aggiornati indirizzi storiografici emersi a livello locale e nazionale e presentando alcuni originali riflessioni. L'attività di studio e ricerca svolta a partire dal 2011, passata attraverso altri due Convegni e altrettanti volumi di Atti, ha ampiamente confermato la centralità di questa parte dell'Italia mediana soprattutto nello sviluppo e nel consolidamento della Resistenza, un aspetto per troppo tempo sottovalutato dalla storiografia nazionale. È stato inoltre dimostrato il considerevole livello raggiunto dalla storiografia umbra e marchigiana su temi, centrali per questi territori, ma solo negli ultimissimi decenni divenuti filoni di studio rilevanti a livello nazionale: l'universo concentrazionario creato dal regime fascista sin dalla fine degli anni Trenta; le pratiche di violenza nazista e fascista contro civili e partigiani; la presenza di combattenti stranieri, delle più svariate provenienze, nelle formazioni partigiane di questi territori

Inconsistency of Sentinel Events and No Gender Difference in the Measurement of Work-Related Stress

Usually, sentinel events and gender are useful variables to propose appropriate intervention strategies for promoting public health. The Italian legislation has incorporated aspects of the scientific literature of stress into law 81/08 and the ministerial circular of November 18, 2010, obliging the detection of work-related stress with specific reference to gender and working environment characteristics. Specifically, the Italian law requires the discovery of sentinel events in the working environment. This study evaluates the role of sentinel events in the detection of work-related stress in relation to gender. The sample includes 249 Italian subjects of a debt collection company divided into two groups (male and female) and distributed in two different categories: Inside Sentinel Events and Outside Sentinel Events. A multifactorial questionnaire, the Organizational and Psychosocial Risk Assessment (OPRA), was administered. The application of two-way ANOVA did not show any statistically significant differences due to gender between the subjects who belonged to the sentinel events group and those who did not belong, as assessed by the Risk Index, the Inventory of Source of Risk, and variables linked to work conditions (work function and seniority). Significant differences were found between men and women only on the index of physical and mental health. Subsequently, three performed linear regression confirm the same results. © The Author(s) 2016