Patient satisfaction and food waste in obstetrics and gynaecology wards

Introduction: Patient satisfaction is an indicator of healthcare quality, and expectation is an important determinant. A component of patient satisfaction is the quality of foodservice. An indicator of this quality is the food wasted by hospitalised patients. In the present study, we investigated patient satisfaction regarding food and foodservice, the expectation on food quality and the amount of food wasted in two obstetrics and gynaecology wards in Northern and Southern Italy. Patients and Methods: A questionnaire, including sociodemographic data, rate of food waste, expectations of food quality and characteristics of food and foodservice, was admini-strated to 550 inpatients in obstetrics and gynaecology wards (275 for each hospital). Univariate analysis was performed to describe the results, and multivariate analysis was carried out to control for sociodemographic data. Results: Northern patients were more satisfied with the quality of food (54.2% vs 36.0%) and foodservice (54.5% vs 38.2%) than southern patients. Northern patients had more positive expectations about the quality of food (69.5% vs 31.6%), whereas southern patients stated that they had no expectations. Southern patients gave more importance to mealtime (72.7% vs 26.2%), and many of them brought food from home to the hospital (30.2% vs 2.2%) through relatives who came to visit them. Southern patients discarded about 41.7% of food served, whereas northern patients discarded only about 15.3%. Discussion: Food waste is a worldwide problem due to its economic, social and environmental effects. Especially in hospitals, food waste could have a negative impact on the overall patient satisfaction

Vertebrate-mediated seed rain and artificial perches contribute to overcome seed dispersal limitation in a Mediterranean old field

Natural regeneration of vegetation is a frequent outcome of land abandonment, although the rate and diversity of such regeneration may be severely restricted by seed dispersal limitation, among other factors. In spite of this, studies aiming to quantify seed rain and test methods to enhance it, such as artificial perches, are still underrepresented in the Mediterranean. In our study, we quantified seed rain density and richness and tested the effects of artificial perches on such rain over a distance gradient on seven Mediterranean island old fields. In each of the seven sites, we positioned three sampling stations, each consisting of 1 seed trap under an artificial perch and 1 as a control on the ground, distributed at 30, 60, and 90 m from natural vegetation remnant. All traps received seeds, suggesting no overall dispersal limitation. Of the 11 seed species found, 10 were fleshy-fruited and dispersed by vertebrates. Seed traps under perches received significantly higher seed rain of fleshy-fruited species dispersed by birds, while ground traps received significantly more seeds of the species also dispersed by mammals, especially Rubus ulmifolius. The distance from the seed source was nonsignificant in all cases. Our study demonstrates the key role of vertebrate-mediated seed dispersal services to overcome dispersal limitation in old fields, as well as the effective contribution of even small artificial perches in contrasting such limitation. The lack of differences over the distance gradient reveal that the upper spatial limit of dispersal limitation was not achieved

Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy

Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patients were tested for chlamydia, syphilis, Mycoplasma genitalium infection, genital herpes and HPV infection. A total of 294 subjects with STIs (male/female ratio about 2:1) were screened. Of the total sample, 79.6% of patients were Italian. MSM accounted for 34.3%, MSW for 29.6%, bisexual men for 5.8% and females for 30.3%. A total of 44.5% of patients had a high education level, 42.5% reported irregular use of condoms, 20.7% reported having had 5-10 partners in the six months prior to the visit and 32.9% were HIV-positive. HPV infection and syphilis were the most prevalent STIs. Conclusions: The most common profile of patients attending our clinic was that of an adult, Italian man with a high level of education, poor use of condoms and a high number of partners. MSM had the highest sex-behavior-related risk for STIs. In addition, our results suggest that all STD teams need to implement counselling topics and recommendations to share with patients, as well as tips on how to approach sexual health education/counselling, thereby promoting patient-centered approaches and educational programs

On the characterisation of paired monotone metrics

Hasegawa and Petz introduced the notion of dual statistically monotone metrics. They also gave a characterisation theorem showing that Wigner-Yanase-Dyson metrics are the only members of the dual family. In this paper we show that the characterisation theorem holds true under more general hypotheses.Comment: 12 pages, to appear on Ann. Inst. Stat. Math.; v2: changes made to conform to accepted version, title changed as wel

Cost-effectiveness analysis of malaria chemoprophylaxis for travellers to West-Africa

BACKGROUND: The importation of malaria to non-endemic countries remains a major cause of travel-related morbidity and a leading cause of travel-related hospitalizations. Currently they are three priority medications for malaria prophylaxis to West Africa: mefloquine, atovaquone/proguanil and doxycycline. We investigate the cost effectiveness of a partial reimbursement of the cheapest effective malaria chemoprophylaxis (mefloquine) for travellers to high risk areas of malaria transmission compared with the current situation of no reimbursement. METHODS: This study is a cost-effectiveness analysis based on malaria cases imported from West Africa to Switzerland from the perspective of the Swiss health system. We used a decision tree model and made a literature research on the components of travel related malaria. The main outcome measure was the cost effectiveness of malaria chemoprophylaxis reimbursement based on malaria and deaths averted. RESULTS: Using a program where travellers would be reimbursed for 80% of the cost of the cheapest malaria chemoprophylaxis is dominant (i.e. cost saving and more effective than the current situation) using the assumption that currently 68.7% of travellers to West Africa use malaria chemoprophylaxis. If the current usage of malaria chemoprophylaxis would be higher, 82.4%, the incremental cost per malaria case averted is € 2'302. The incremental cost of malaria death averted is € 191'833.The most important factors influencing the model were: the proportion of travellers using malaria chemoprophylaxis, the probability of contracting malaria without malaria chemoprophylaxis, the cost of the mefloquine regimen, the decrease in the number of travellers without malaria chemoprophylaxis in the reimbursement strategy. CONCLUSIONS: This study suggests that a reimbursement of 80% of the cost of the cheapest effective malaria chemoprophylaxis (mefloquine) for travellers from Switzerland to West Africa is highly effective in terms of malaria cases averted and is cost effective to the Swiss health system. These data are relevant to discussions about the cost effectiveness of malaria chemoprophylaxis reimbursement for vulnerable groups such as those visiting friends and relatives who have the highest risk of malaria, who are least likely to use chemoprophylaxis

Ulcère de Buruli chez un voyageur français au Sénégal

L’ulcère de Buruli (UB) est une infection endémique du tissu sous-cutané causée par Mycobacterium ulcerans, un agent pathogène environnemental. C’est une affection émergente caractérisée par la nécrose du tissu sous-cutané aboutissant à un ulcère chronique, d’extension progressive et qui reste indolore. La maladie a un impact socio-économique majeur dans les populations des pays concernés par l’endémie. L’ulcère de Buruli est présent à l’état endémique dans 17 pays et des cas isolés ont été rapportés dans 10 autres pays. A ce jour, peu de cas ont été rapportés chez le voyageur. Nous relatons ici un cas d’ulcère de Buruli, confirmé par la détection de matériel génétique de M. ulcerans, chez un voyageur ayant contracté l’infection au Sénégal, pays dans lequel aucun cas d’ulcère de Buruli n’a jusqu’alors été rapporté

Malaria chemoprophylaxis recommendations for immigrants to Europe, visiting relatives and friends - a Delphi method study

BACKGROUND: Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs. METHODS: European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis. RESULTS: The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe. CONCLUSIONS: Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics

Combined platelet-rich plasma and lipofilling treatment provides great improvement in facial skin-induced lesion regeneration for scleroderma patients

Background: The use of stem cells, including mesenchymal stem cells (MSCs), for regenerative medicine is gaining interest for the clinical benefits so far obtained in patients. This study investigates the use of adipose autologous tissue in combination with platelet-rich plasma (PRP) to improve the clinical outcome of patients affected by systemic sclerosis (SSc). Methods: Adipose-derived mesenchymal stem cells (AD-MSCs) and PRPs were purified from healthy donors and SSc patients. The multilineage differentiation potential of AD-MSCs and their genotypic-phenotypic features were investigated. A cytokine production profile was evaluated on AD-MSCs and PRPs from both healthy subjects and SSc patients. The adipose tissue-derived cell fraction, the so-called stromal vascular fraction (SVF), was coinjected with PRP in the perioral area of SSc patients. Results: Histopathological and phenotypical analysis of adipose tissue from SSc patients revealed a disorganization of its distinct architecture coupled with an altered cell composition. Although AD-MSCs derived from SSc patients showed high multipotency, they failed to sustain a terminally differentiated progeny. Furthermore, SVFs derived from SSc patients differed from healthy donors in their MSC-like traits coupled with an aberrant cytokine production profile. Finally, the administration of PRP in combination with autologous SVF improved buccal's rhyme, skin elasticity and vascularization for all of the SSc patients enrolled in this study. Conclusions: This innovative regenerative therapy could be exploited for the treatment of chronic connective tissue diseases, including SSc

A Class of Non-Parametric Statistical Manifolds modelled on Sobolev Space

We construct a family of non-parametric (infinite-dimensional) manifolds of finite measures on Rd. The manifolds are modelled on a variety of weighted Sobolev spaces, including Hilbert-Sobolev spaces and mixed-norm spaces. Each supports the Fisher-Rao metric as a weak Riemannian metric. Densities are expressed in terms of a deformed exponential function having linear growth. Unusually for the Sobolev context, and as a consequence of its linear growth, this "lifts" to a nonlinear superposition (Nemytskii) operator that acts continuously on a particular class of mixed-norm model spaces, and on the fixed norm space W²'¹ i.e. it maps each of these spaces continuously into itself. It also maps continuously between other fixed-norm spaces with a loss of Lebesgue exponent that increases with the number of derivatives. Some of the results make essential use of a log-Sobolev embedding theorem. Each manifold contains a smoothly embedded submanifold of probability measures. Applications to the stochastic partial differential equations of nonlinear filtering (and hence to the Fokker-Planck equation) are outlined

Study of WW boson production in association with beauty and charm

The associated production of a $W$ boson with a jet originating from either a light parton or heavy-flavor quark is studied in the forward region using proton-proton collisions. The analysis uses data corresponding to integrated luminosities of 1.0 and $2.0\,{\rm fb}^{-1}$ collected with the LHCb detector at center-of-mass energies of 7 and 8 TeV, respectively. The $W$ bosons are reconstructed using the $W\to\mu\nu$ decay and muons with a transverse momentum, $p_{\rm T}$, larger than 20 GeV in the pseudorapidity range $2.0 20$ GeV and $2.2 < \eta < 4.2$. The sum of the muon and jet momenta must satisfy $p_{\rm T} > 20$ GeV. The fraction of $W+$jet events that originate from beauty and charm quarks is measured, along with the charge asymmetries of the $W\!+\!b$ and $W\!+\!c$ production cross-sections. The ratio of the $W+$jet to $Z+$jet production cross-sections is also measured using the $Z\to\mu\mu$ decay. All results are in agreement with Standard Model predictions