Health Care Transition Program for Adolescents with Spina Bifida

The purpose of this evidence-based project was to evaluate the feasibility of implementing an NP facilitated formal transition program for adolescents with Spina Bifida. There is an increased awareness of the need for health care transition for youth with special health care needs (YSHCN) due to the 2009-2010 Maternal Child Health Branch National Survey findings that only 40% of YSHCN receive adequate support for transition that meets the core outcome measures. Recent studies have investigated transition in youth with chronic disease specific conditions such as diabetes, cystic fibrosis, and congenital heart defects, and provide valuable insight into possible strategies for transition management. However, there is limited translation of the evidence to transition programs specific to adolescents with Spina bifida (SB) that are focused on transition readiness or knowledge related to self-care management. Adolescents with SB face many challenges due to their medical complexities and potential development of secondary health conditions as young adults. Adolescents with Spina bifida often have difficulty with knowledge acquisition, attention, organization, and problem solving, all factors that are necessary to facilitate successful healthcare transition. An NP transition program was successfully implemented into a multidisciplinary SB clinic. The results of this transition program support a structured needs assessment and specific educational interventions with this unique population. The SB healthcare transition project can serve as a model for future programs with youth that have complex medical conditions

A Description Model for Regeneration through Urban Tourism in Rural Towns with Underused Historic Real Estate

Abstract This paper deals with the construction of a description model that will be helpful for an actual decision aiding situation posed by the urban planner for tourism development of rural towns in Sicilian hinterland areas. The decision problem concerns the town of Cianciana, which in recent years has become the protagonist of a particular international tourism phenomenon. We propose a multi-criteria evaluation framework for the rehabilitation of the historic town centre through tourism development. The description problem model that is presented here is focused on aiding decision makers to identify the best usage strategy of under-utilized historic real estate for tourist accommodation. Although the evaluation framework has been inspired by the particular case of Cianciana, it would fit well for evaluations undertaken in analogue circumstances

Food and religion in Sicily: new green tourist destination by an ancient route from the past.

The Francigena Way (Via Francigena) is a long international itinerary that was awarded recognition as a Culture Route of the Council of Europe. It starts in Canterbury (UK), touches 13 European regions and ends in Rome. An ancient track of this route is in Sicily (Southern Italy), and its name is Magna Via Francigena (Great Francigena Way). This track is a pilgrimage route that con-nects two ancient port cities, Palermo and Agrigento, passing through internal rural territories that now deal with the exodus of population from rural to urban areas. The route passes through the Sicilian territory named “Upper-Belìce corleonese”, a rural area around the city of Corleone (a little village known worldwide for the sad Mafia events) that includes a number of municipalities. In the past, this religious pilgrimage was a fundamental part of the expression of faith for Christians and now still represents for Sicilians a strong symbol of Christian identity. In recent decades, pilgrimage tourism around the world has grown significantly each year. The aim of the study is to know the pilgrims’ motivations for choosing the Magna Via Francigena pilgrimage as a vacation and any pos-sible similarities between pilgrimage tourism and food and wine tourism, in the wider context of sustainable and slow tourism. The Policy Delphi method was applied to collect the opinions of the stakeholders involved. The study highlighted the strong link between religious motivations and local enogastronomy, culture, art and nature. Results will support policy-making in the development of integrated territorial tourist marketing strategies

DOES THE INHIBITION OF P2Y12 INHIBIT THE PRODUCTION OF THROMBOXANE A2 BY PLATELETS?

Patients with acute coronary syndromes (ACS) are treated with dual antiplatelet therapy (DAPT), which includes aspirin, an inhibitor of thromboxane A2 (TxA2) production, and an antagonist of the P2Y12 receptor for ADP. Based on the recent observation that P2Y12 antagonists also inhibit the platelet production of TxA2, it has been suggested that patients with ACS might be safely treated with P2Y12 antagonists only. However, the observation that platelets congenitally deficient of P2Y12 synthesize normal amounts of TxA2 contrasts the results obtained with P2Y12 antagonists. To test whether the reported inhibitory effect of P2Y12 antagonists on TxA2 production is due to off-target effects, or secondary to inhibition of platelet aggregation (PA). Serum TxB2 was measured in 2 patients with inherited P2Y12 deficiency and 7 healthy subjects in presence/absence of increasing concentrations of P2Y12 antagonists added in vitro, and in 20 patients treated with 10 mg/d prasugrel (P2Y12 antagonist) or placebo for 14 days in a randomized, double-blind, cross-over study. TxB2 levels were also measured after stimulation of citrate-PRP by collagen (0,5\ub5g/mL) or arachidonic acid (1mM) in an aggregometer in presence/absence of P2Y12 antagonists, under stirring and non-stirring conditions (PA does not occur without stirring). P2Y12 antagonists did not decrease serum TxB2 levels both in vitro and ex vivo (prasugrel-treated patients). They partially inhibited TxB2 production under stirring, but not under non-stirring conditions. In conclusion, P2Y12 antagonists do not inhibit the platelet TxA2 production; therefore, there is no pharmacological evidence that aspirin should be withheld in patients with ACS

Publicaciones científicas a través de revistas académicas de acceso abierto

El presente trabajo tiene por objeto analizar los criterios editoriales para revistas de formato digital, con el objeto de contribuir a mejorar la difusión de las publicaciones científicas. Esta difusión se puede alcanzar de forma directa o por vías indirectas. La difusión directa tiene la limitación de la cantidad que se puede imprimir. La inclusión en bibliotecas reconocidas constituye un indicador de difusión de alto valor, implica disponibilidad de la revista para un número mayor de usuarios. La difusión indirecta por inclusión en bases de datos temáticas logra una mayor difusión y visibilidad internacional. El análisis realizado se ha basado en los criterios observados por los siguientes servicios: el índice Red de Revistas Científicas de América Latina y El Caribe, España y Portugal Red ALyC, el proyecto Scientific Electronic Library Online (SciELO), el directorio Directory of Open Access Journals (DOAJ), el catálogo LATINDEX y los índices internacionales Thompson Reuters (ISI) y Scopus de Elsevier. También se analizó la Licencia Creative Commons dada su significación para la difusión de artículos académicos en línea. La relevancia que presenta la incorporación de los trabajos que se publican en las revistas especializadas incluidas en los distintos índices y directorios, pone de manifiesto un notable aumento del interés por publicar por parte de los autores, quienes perciben la relevancia que sus artículos pueden adquirir con el potencial de la distribución en línea.Tema 6: Transferencia de conocimientos generados por la investigación contable. Publicaciones científicas. Propiedad intelectual. Extensión universitariaFacultad de Ciencias Económica

Publicaciones científicas a través de revistas académicas de acceso abierto

El presente trabajo tiene por objeto analizar los criterios editoriales para revistas de formato digital, con el objeto de contribuir a mejorar la difusión de las publicaciones científicas. Esta difusión se puede alcanzar de forma directa o por vías indirectas. La difusión directa tiene la limitación de la cantidad que se puede imprimir. La inclusión en bibliotecas reconocidas constituye un indicador de difusión de alto valor, implica disponibilidad de la revista para un número mayor de usuarios. La difusión indirecta por inclusión en bases de datos temáticas logra una mayor difusión y visibilidad internacional. El análisis realizado se ha basado en los criterios observados por los siguientes servicios: el índice Red de Revistas Científicas de América Latina y El Caribe, España y Portugal Red ALyC, el proyecto Scientific Electronic Library Online (SciELO), el directorio Directory of Open Access Journals (DOAJ), el catálogo LATINDEX y los índices internacionales Thompson Reuters (ISI) y Scopus de Elsevier. También se analizó la Licencia Creative Commons dada su significación para la difusión de artículos académicos en línea. La relevancia que presenta la incorporación de los trabajos que se publican en las revistas especializadas incluidas en los distintos índices y directorios, pone de manifiesto un notable aumento del interés por publicar por parte de los autores, quienes perciben la relevancia que sus artículos pueden adquirir con el potencial de la distribución en línea.Tema 6: Transferencia de conocimientos generados por la investigación contable. Publicaciones científicas. Propiedad intelectual. Extensión universitariaFacultad de Ciencias Económica

Publicaciones científicas a través de revistas académicas de acceso abierto

El presente trabajo tiene por objeto analizar los criterios editoriales para revistas de formato digital, con el objeto de contribuir a mejorar la difusión de las publicaciones científicas. Esta difusión se puede alcanzar de forma directa o por vías indirectas. La difusión directa tiene la limitación de la cantidad que se puede imprimir. La inclusión en bibliotecas reconocidas constituye un indicador de difusión de alto valor, implica disponibilidad de la revista para un número mayor de usuarios. La difusión indirecta por inclusión en bases de datos temáticas logra una mayor difusión y visibilidad internacional. El análisis realizado se ha basado en los criterios observados por los siguientes servicios: el índice Red de Revistas Científicas de América Latina y El Caribe, España y Portugal Red ALyC, el proyecto Scientific Electronic Library Online (SciELO), el directorio Directory of Open Access Journals (DOAJ), el catálogo LATINDEX y los índices internacionales Thompson Reuters (ISI) y Scopus de Elsevier. También se analizó la Licencia Creative Commons dada su significación para la difusión de artículos académicos en línea. La relevancia que presenta la incorporación de los trabajos que se publican en las revistas especializadas incluidas en los distintos índices y directorios, pone de manifiesto un notable aumento del interés por publicar por parte de los autores, quienes perciben la relevancia que sus artículos pueden adquirir con el potencial de la distribución en línea.Tema 6: Transferencia de conocimientos generados por la investigación contable. Publicaciones científicas. Propiedad intelectual. Extensión universitariaFacultad de Ciencias Económica

Controversies in the treatment of mild asthma. What novelties and practical implications?

Mild asthma is prevalent in childhood and causes as many as 30%–40% asthma exacerbations requiring emergency visits. The management of "intermittent" and "mild persistent" asthma phenotypes is still a matter of debate, even if the role of inhaled corticosteroids, both continuous and intermittent, is a cornerstone in this field. Recent updates of the guidelines on the strategies to manage these patients are coming, since the role of inflammation in these asthma phenotypes is crucial, as well as the potential side effect and risks of short-acting beta 2 agonists overuse, prescribed as the only "as-needed" treatments. In this paper, we overview the new (r)evolution regarding intermittent and mild persistent asthma management

Temporal changes in cardiac oxidative stress, inflammation and remodeling induced by exercise in hypertension: Role for local angiotensin II reduction

Exercise training reduces renin-angiotensin system (RAS) activation, decreases plasma and tissue oxidative stress and inflammation in hypertension. However, the temporal nature of these phenomena in response to exercise is unknown. We sought to determine in spontaneously hypertensive rats (SHR) and age-matched WKY controls the weekly effects of training on blood pressure (BP), plasma and left ventricle (LV) Ang II and Ang-(1–7) content (HPLC), LV oxidative stress (DHE staining), gene and protein expression (qPCR and WB) of pro-inflammatory cytokines, antioxidant enzymes and their consequence on hypertension-induced cardiac remodeling. SHR and WKY were submitted to aerobic training (T) or maintained sedentary (S) for 8 weeks; measurements were made at weeks 0, 1, 2, 4 and 8. Hypertension-induced cardiac hypertrophy was accompanied by acute plasma Ang II increase with amplified responses during the late phase of LV hypertrophy. Similar pattern was observed for oxidative stress markers, TNF alpha and interleukin-1β, associated with cardiomyocytes’ diameter enlargement and collagen deposition. SHR-T exhibited prompt and marked decrease in LV Ang II content (T1 vs T4 in WKY-T), normalized oxidative stress (T2), augmented antioxidant defense (T4) and reduced both collagen deposition and inflammatory profile (T8), without changing cardiomyocytes’ diameter and LV hypertrophy. These changes were accompanied by decreased plasma Ang II content (T2-T4) and reduced BP (T8). SHR-T and WKY-T showed parallel increases in LV and plasma Ang-(1–7) content. Our data indicate that early training-induced downregulation of LV ACE-AngII-AT1 receptor axis is a crucial mechanism to reduce oxidative/pro-inflammatory profile and improve antioxidant defense in SHR-T, showing in addition this effect precedes plasma RAS deactivation

Comparison of protein carbonyl (Pco), paraoxonase-1 (pon1) and c-reactive protein (crp) as diagnostic and prognostic markers of septic inflammation in dogs

Reliable diagnostic and prognostic markers of sepsis are lacking, but essential in veterinary medicine. We aimed to assess the accuracy of C-Reactive Protein (CRP), protein carbonyls (PCO) and paraoxonase-1 (PON1) in differentiating dogs with sepsis from those with sterile inflammation and healthy ones, and predict the outcome in septic dogs. These analytes were retrospectively evaluated at admission in 92 dogs classified into healthy, septic and polytraumatized. Groups were compared using the Kruskal–Wallis test, followed by a Mann–Whitney U test to assess differences between survivors and non-survivors. Correlation between analytes was assessed using the Spearman’s test, and their discriminating power was assessed through a Receiver Operating Characteristic (ROC) curve. PON1 and CRP were, respectively, significantly lower and higher in dogs with sepsis compared with polytraumatized and clinically healthy dogs (p < 0.001 for both the analytes), and also in dogs with trauma compared with healthy dogs (p = 0.011 and p = 0.017, respectively). PCO were significantly increased in septic (p < 0.001) and polytraumatized (p < 0.005) as compared with healthy dogs. PON1 and CRP were, respectively, significantly lower and higher in dogs that died compared with survivors (p < 0.001 for both analytes). Ultimately, evaluation of CRP and PON1 at admission seems a reliable support to diagnose sepsis and predict outcomes