Vulcani: esplosioni ed effusioni

Si tratta dei pannelli realizzati per la mostraVulcani: Esplosioni ed effusioni Festival della Scienza di Genova 2007 Palazzo Ducale – Sottoporticato, Genova Una nuova mostra interattiva delll’Istituto Nazionale di Geofisica e Vucanologia, alla scoperta dei segreti del nostro pianeta e del mondo spettacolare dei vulcani. Organizzato come un “racconto”, è un lungo viaggio dalla nascita Terra ad oggi che aiuta a comprendere il ruolo fondamentale dei vulcani nella storia del nostro pianeta. Inizia con una proiezione 3d seguita da un filmato spettacolare e coinvolgente di eruzioni vulcaniche. Nella mostra si incontrano poi un grande modello di vulcano che può essere “acceso” in modalità interattiva, producendo un’eruzione esplosiva con gran fragore, sezioni di vulcano per scoprire “cosa c’è sotto”, plastici associati ad una speciale proiezione che permette di visualizzare sia l’eruzione sia l’interno del vulcano. E ancora rocce vulcaniche e un laboratorio per esperienze guidate, per capire il meccanismo che provoca l’eruzione, studiando il legame tra gas, pressione ed esplosione, anche utilizzando ulteriori modellini di vulcano. Il fatto che spesso le eruzioni vulcaniche siano accompagnate da attività sismica ci introduce alla parte finale della mostra, dedicata ai terremoti. L’obiettivo complessivo della mostra è quello di comunicare e far comprendere l’importanza del lavoro di ricerca e di controllo che svolge l’INGV e il riflesso che questo ha nella vita di ciascuno di noi. Si tratta, in sostanza, di “raccontare” le attività scientifiche svolte dall’Istituto inquadrandole dal punto di vista del visitatore.Con i contributi dell’Associazione per il Festival della Scienza e del Dipartimento della Protezione CivilePublished5.8. TTC - Formazione e informazionereserve

Volcanoes: effusions and explosions. Interactive exhibits to understand how volcanoes work

The Educational & Outreach Group (EOG) of the Istituto Nazionale di Geofisica & Vulcanologia created a portable museum to provide educational opportunities in volcanology, volcanic risk and Earth science for students and visitors. The EOG developed this project for the "Festival della Scienza", organized in Genoa, Italy, in October - November, 2007, which was a parade of over 200 events, including scientific and technological exhibitions, workshops, meetings, lectures, books and video presentations. In this museum visitors can successively see many posters and movies and play with interactive exhibits. A little 3D-movie shows the Big Bang, the formation of Solar System and, in particular the formation of the Earth. Many interactive exhibits illustrate why, where and when earthquakes and volcanic eruptions occur around the world and allow to introduce the visitor to the plate tectonics theory. A 3D magnetic plate tectonic puzzle can be put down and reconstructed by visitors to understand the Earth’s surface configuration. Then two other 3D Earth models show what drives the plates and the inner Earth structure. An interactive program illustrates where and when earthquakes and volcanic eruptions occur in accelerated time on maps of various areas around the world. Playing with a block diagram it is possible to produce an earthquake along a 1 meter long strike slip fault in a destroying all the man-made constructions close to it. A little movie introduces to volcanoes’ world. Two small interactive exhibits allow visitors to understand the mechanism for the explosive and the effusive eruptions. Two other exciting interactive exhibits allow visitors to “create” two different eruptions: the explosive and the effusive ones. It is possible to get inside a volcano (a 2 meter high interactive exhibit) to attend an eruption from the magmatic chamber to the Earth surface. A big hall is completed dedicated to Italian volcanoes (Vesuvio, Campi Flegrei, Etna, Stromboli, Vulcano, Colli Albani); some of them are reproduced with 3D models or described by short movies. The museum finishes with the visit of the volcanic survey hall of Stromboli, seeing - in real time - seismic data, three different webcams, geochemical and strain data. The INGV Museum had remarkably successful, reaching more than 7,500 children and adults yet in 13 days, also thanks to 30 volcanologists as very special guides. The Educational & Outreach Group: M. Pignone, A. Tertulliani, M. De Lucia, M. Di Vito, P. Landi, P. Madonia, M. Martini, R. Nave, M. Neri, P. Scarlato, J. Taddeucci, R. Moschillo, S. Tarquini, G. Vilardo, A. Bonforte, L. Calderone, F. Cannavò, W. De Cesare, P. Ficeli, S. Inguaggiato, M. Mattia, G. Puglisi, S. Morici, D. Reitano, D. Richichi, G. Scarpato, B. Angioni, F. Di Laura, S. Palone, D. Riposat

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Relationship of job satisfaction, psychological distress and stress-related biological parameters among healthy nurses: A longitudinal study

Relationship of Job Satisfaction, Psychological Distress and Stress‐Related Biological Parameters among Healthy Nurses: A Longitudinal Study: Monica Amati, et al. Department of Molecular Pathology and Innovative Therapies, Clinic of Occupational Medicine, Polytechnic University of Marche, ItalyObjectiveTo examine the relationship between job satisfaction, psychological distress, psychosocial processes and stress‐related biological factors, and to evaluate whether over time changes of work satisfaction could affect the immunological‐inflammatory status of workers.MethodsOne hundred and one nurses were enrolled at the Clinic of Occupational Medicine, Polytechnic University of Marche, Ancona, Italy. Perceived job satisfaction, psychological distress, and social support were assessed every 4 mo over a 1‐yr period using 4 self‐reported questionnaires. T lymphocytes CD3, CD4+, CD8+, CD8+‐CD57+, B lymphocyte CD19+, NK cells CD56+, and NK cell activity were determined.ResultsJob satisfaction was associated with reduced psychological distress and was characterized by low cell numbers of CD8+suppressor T cells, CD8+‐CD57+activated T cells, CD56+NK cells and low IL‐6 levels. Over time changes in psychological parameters were related to changes in the immunological‐inflammatory variables. Subjects who increased their job satisfaction showed a reduced psychological stress associated with reduced number of CD8+‐CD57+activated T cells and inflammatory cytokines.ConclusionsJob (dis)satisfaction is related with psychological mechanisms in stress affecting cellular immune function