Pediatric palliative care

The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pediatric patients experience all the clinical, psychological, ethical and spiritual problems that severe, irreversible disease and death entail. The international literature indicates a prevalence of incurable disease annually affecting 10/10,000 young people from 0 to 19 years old, with an annual mortality rate of 1/10,000 young people from birth to 17 years old. The needs of this category of patients, recorded in investigations conducted in various parts of the world, reveal much the same picture despite geographical, cultural, organizational and social differences, particularly as concerns their wish to be treated at home and the demand for better communications between the professionals involved in their care and a greater availability of support services. Different patient care models have been tested in Italy and abroad, two of institutional type (with children staying in hospitals for treating acute disease or in pediatric hospices) and two based at home (the so-called home-based hospitalization and integrated home-based care programs). Professional expertise, training, research and organization provide the essential foundations for coping with a situation that is all too often underestimated and neglected

The influence of bentonite treatment on soil hydraulic properties: application to the cap cover of a french disposal for nuclear waste of low activity

Il Centre de Stockage de la Manche è una discarica per rifiuti radioattivi. Per garantire condizioni di sicurezza a lungo termine, la copertura della discarica deve essere il più impermeabile possibile. Per garantire ciò si propone il trattamento alla bentonite dello strato minerale della copertura. La tesi analizza gli effetti del trattamento alla bentonite sulle proprietà  del terreno, sulla conducibilità  idraulica in condizioni sature e insature, sulla suscettibilità  all'erosion

Reattivit\ue0\ua0 psicofisiologica ad uno stimolo doloroso preavvertito in pazienti con dolore cronico

Lo studio descrive gli effetti dell'anticipazione di uno stimololo doloroso sulla reattivit\ue0 psicofisiologic

Italian Paediatric Health-Related Quality of life (HRQoL) Measurements

Quality of Life Newslette

Convolutional Neural Networks for the Identification of African Lions from Individual Vocalizations

The classification of vocal individuality for passive acoustic monitoring (PAM) and census of animals is becoming an increasingly popular area of research. Nearly all studies in this field of inquiry have relied on classic audio representations and classifiers, such as Support Vector Machines (SVMs) trained on spectrograms or Mel-Frequency Cepstral Coefficients (MFCCs). In contrast, most current bioacoustic species classification exploits the power of deep learners and more cutting-edge audio representations. A significant reason for avoiding deep learning in vocal identity classification is the tiny sample size in the collections of labeled individual vocalizations. As is well known, deep learners require large datasets to avoid overfitting. One way to handle small datasets with deep learning methods is to use transfer learning. In this work, we evaluate the performance of three pretrained CNNs (VGG16, ResNet50, and AlexNet) on a small, publicly available lion roar dataset containing approximately 150 samples taken from five male lions. Each of these networks is retrained on eight representations of the samples: MFCCs, spectrogram, and Mel spectrogram, along with several new ones, such as VGGish and stockwell, and those based on the recently proposed LM spectrogram. The performance of these networks, both individually and in ensembles, is analyzed and corroborated using the Equal Error Rate and shown to surpass previous classification attempts on this dataset; the best single network achieved over 95% accuracy and the best ensembles over 98% accuracy. The contributions this study makes to the field of individual vocal classification include demonstrating that it is valuable and possible, with caution, to use transfer learning with single pretrained CNNs on the small datasets available for this problem domain. We also make a contribution to bioacoustics generally by offering a comparison of the performance of many state-of-the-art audio representations, including for the first time the LM spectrogram and stockwell representations. All source code for this study is available on GitHub

Biofeedback and progressive muscle relaxation in the treatment of headache in childhood, and the long term regular monitoring of their effect

Primary headache is common in childhood. The painful symptoms interfere with the children\u2019s and adolescents\u2019 performance at school, in games and in their family lives. After an initial diagnosis, taking not only the physical, but also the affective, behavioral and situational factors into account, it is consequently essential to provide treatment as promptly as possible to avoid the condition becoming chronic. In recent years, the literature has increasingly supported the application of non-pharmacological treatments to headache in childhood, but few studies have routinely monitored the clinical and physiological modifications induced by such treatments in the course of a short- and long-term follow-up. The aim of the present study was to analyze the effectiveness of two different non-pharmacological treatments, electromyographic biofeedback (BFB) and progressive muscle relaxation (PMR), by means of a systematic assessment of the clinical and physiological changes observed after the treatment and at various follow-up points for up to 1 year. Twenty children took part in the study, 10 treated with BFB and 10 with PMR. All the children had suffered from recurrent headache for at least 6 months. They were given a headache diary to complete before the treatment, at the end of the treatment and then at 1, 3, 6 and 12 months of follow-up. The variables analyzed were: headache frequency, duration and intensity, headache index, muscle tension (EMG), intake of medication, percentage of improvement. The results showed that both treatments led to a significant improvement in the frequency of the painful attacks and in the headache index. PMR also induced a reduction in the duration of the headache episodes. After treatment, there was a marked reduction in the use of medication and the mean percentage of improvement tended to increase with time, remaining consistently higher than 50% at all the time points considered. On the whole, the improvements tended progressively to be consolidated and even increase, especially from the third month of follow-up onwards. Our findings confirm the effectiveness of non-pharmacological therapies in the treatment of childhood headache and support the likelihood of stable and generalized short- and long-term therapeutic effects