Multidisciplinary team meetings in palliative care: an ethnographic study

OBJECTIVES: Multidisciplinary team meetings are a regular feature in the provision of palliative care, involving a range of professionals. Yet, their purpose and best format are not necessarily well understood or documented. This article describes how hospital and community-based palliative care multidisciplinary team meetings operate to elucidate some of their main values and offer an opportunity to share examples of good practice. METHODS: Ethnographic observations of over 70 multidisciplinary team meetings between May 2018 and January 2020 in hospital and community palliative care settings in intercity London. These observations were part of a larger study examining palliative care processes. Fieldnotes were thematically analysed. RESULTS: This article analyses how the meetings operated in terms of their setup, participants and general order of business. Meetings provided a space where patients, families and professionals could be cared for through regular discussions of service provision. CONCLUSIONS: Meetings served a variety of functions. Alongside discussing the more technical, clinical and practical aspects that are formally recognised aspects of the meetings, an additional core value was enabling affectual aspects of dealing with people who are dying to be acknowledged and processed collectively. Insight into how the meetings are structured and operate offer input for future practice

A study of tilt change recorded from July to October 2006 at the Phlegraean Fields (Naples, Italy)

The tiltmetric dataset of Phlegraean Fields area showed a discrete correlation with the volcanic dynamics, suggesting that tiltmetric monitoring is important for the surveillance of active volcanic areas. Tilt data recorded in 2006 at 2 stations belonging to the monitoring network of the Osservatorio Vesuviano (INGV, National Institute for Geophysics and Volcanology, Italy) in the Phlegraean Fields are discussed in this paper. The acquired signals have shown a strong tiltmetric inversion that took place from the end of July 2006. After correcting tilt variations to eliminate the influence of temperature (influencing 90% of the signal at OLB station, hereafter OLB) a significant value of the tilt still remains. This change is related to a local inflation episode lasting 3 months, during an unrest phase that started 2 years before. It is interesting to note that tilt amplitude is much greater at OLB than the slope of the displacement field predicted by the theoretical inflation models, but data show that this field is not homogeneous and in some areas very tilted. Moreover, in the last days before the end of tilt inversion, a low energy seismic swarm happened at about 1 km of distance from the tiltmetric station by hundreds of VT (Volcano-Tectonics) and LP (Long-Period) events

Time-resolved x-ray spectroscopy of optical-field-ionized plasmas

The time-dependent soft X-ray emission of helium and nitrogen plasmas generated by optical-field ionization is reported. The experiments were carried out by focusing pulses of the high-power Ti:sapphire laser of the Lund Institute of Technology (lambda = 796 nm, pulse duration 150 fs, pulse energy 150 mJ) to a 50-mu m diameter spot close to a nozzle, using He and N-2 as target gases. The emission on He+, N4+, and N3+ resonance lines was recorded by means of a flat-field grating spectrometer coupled to an X-ray streak camera. A pronounced difference in the temporal shape of the emission of the Lyman-alpha line of hydrogen-like helium and of the 2p-3d resonance lines of lithium-like and beryllium-like nitrogen was observed. The helium line exhibited an initial spike followed by a slow revival of the emission, whereas the nitrogen lines showed a slow decay after a fast initial rise. These observations are explained with the help of simulations

Volcanic Risk System (SRV): ASI Pilot Project to Support The Monitoring of Volcanic Risk In Italy by Means of EO Data

The ASI-SRV(Sistema Rischio Vulcanico) project started at the beginning of the 2007 is funded by the Italian Space Agency (ASI) in the frame of the National Space Plan 2003-2005 under the Earth Observations section for natural risks management. Coordinated by the Istituto Nazionale di Geofisica e Vulcanologia (INGV), which is responsible at national level for the volcanic monitoring, the project has as main objective to develop a pre-operative system based on EO data and ground measurements integration to support the volcanic risk monitoring of the Italian Civil Protection Department. The project philosophy is to implement specific modules which allow to process, store and visualize through Web GIS tools EO derived parameters considering three activity phases: 1) knowledge and prevention; 2) crisis; 3) post crisis. In order to combine effectively the EO data and the ground networks measurements the system will implement a multi-parametric analysis tool, which represents and unique tool to analyze contemporaneously a large data set of data in “near real time”. The SRV project will be tested his operational capabilities on three Italian Volcanoes: Etna,Vesuvio and Campi Flegrei

The Light Microscopy of Triglyceride Digestion

During fat digestion (lipolysis) a number of physiochemical events can be seen directly by light microscopy. Hydrolysis of emulsified fat droplets bylipases at pHs above about 6.5 proceeds with the formation of visible product phases that may include both crystalline as well as liquid crystalline phases. The crystalline phase is primarily calcium-fatty acid soap and its formation is favored by high calcium concentrations, alkaline pHs, and inhibited by low pH and monoglycerides. The formation of liquid crystalline product phases are favored by low calcium-concentrations. monoglycerides and lipid saturated bile salt solutions. Both phases are solubilized by bile salts but the crystalline phase to a much lesser degree. Colored and fluorescent hydrophobic solutes that a re dissolved in long cha in triglyceride appear to flow directly into the liquid crystalline product phases where they can be codispersed with the digested lipid by bile salts. Measurements of the shrinking diameters of digesting fat droplets show that enzyme activity on individual droplet~ falls rapidly during lipolysis. This suggests that lipase molecules a re physically displaced from the substrate interface during lipolysis and dispersed in the product phases

Volcanic Risk System (SRV): ASI Pilot Project to Support The Monitoring of Volcanic Risk In Italy by Means of EO Data

The ASI-SRV(Sistema Rischio Vulcanico) project started at the beginning of the 2007 is funded by the Italian Space Agency (ASI) in the frame of the National Space Plan 2003-2005 under the Earth Observations section for natural risks management. Coordinated by the Istituto Nazionale di Geofisica e Vulcanologia (INGV), which is responsible at national level for the volcanic monitoring, the project has as main objective to develop a pre-operative system based on EO data and ground measurements integration to support the volcanic risk monitoring of the Italian Civil Protection Department. The project philosophy is to implement specific modules which allow to process, store and visualize through Web GIS tools EO derived parameters considering three activity phases: 1) knowledge and prevention; 2) crisis; 3) post crisis. In order to combine effectively the EO data and the ground networks measurements the system will implement a multi-parametric analysis tool, which represents and unique tool to analyze contemporaneously a large data set of data in “near real time”. The SRV project will be tested his operational capabilities on three Italian Volcanoes: Etna,Vesuvio and Campi Flegrei

Volcanic Risk System (SRV): ASI Pilot Project to Support The Monitoring of Volcanic Risk In Italy by Means of EO Data

The ASI-SRV(Sistema Rischio Vulcanico) project started at the beginning of the 2007 is funded by the Italian Space Agency (ASI) in the frame of the National Space Plan 2003-2005 under the Earth Observations section for natural risks management. Coordinated by the Istituto Nazionale di Geofisica e Vulcanologia (INGV), which is responsible at national level for the volcanic monitoring, the project has as main objective to develop a pre-operative system based on EO data and ground measurements integration to support the volcanic risk monitoring of the Italian Civil Protection Department. The project philosophy is to implement specific modules which allow to process, store and visualize through Web GIS tools EO derived parameters considering three activity phases: 1) knowledge and prevention; 2) crisis; 3) post crisis. In order to combine effectively the EO data and the ground networks measurements the system will implement a multi-parametric analysis tool, which represents and unique tool to analyze contemporaneously a large data set of data in “near real time”. The SRV project will be tested his operational capabilities on three Italian Volcanoes: Etna,Vesuvio and Campi Flegrei.I.N.G.V. - O.V. SEZIONE DI NAPOLI I.R.E.A. - C.N.R. E.S.A. A.S.I.PublishedNapoli1.10. TTC - Telerilevamentoope

Monitoring of Land Subsidence in Ravenna Municipality Using Integrated SAR - GPS Techniques: Description and First Results

The Emilia Romagna Region (N-E Italy) and in particular the Adriatic Sea coastline of Ravenna, is affected by a noticeable subsidence that started in the 1950s, when the exploitation of on and off-shore methane reservoirs began, along with the pumping of groundwater for industrial uses. In such area the current subsidence rate, even if lower than in the past, reaches the -2 cm/y. Over the years, local Authorities have monitored this phenomenon with different techniques: spirit levelling, GPS surveys and, more recently, Differential Interferometric Synthetic Aperture Radar (DInSAR) techniques, confirming the critical situation of land subsidence risk. In this work, we present the comparison between the results obtained with DInSAR and GPS techniques applied to the study of the land subsidence in the Ravenna territory. With regard to the DInSAR, the Small Baseline Subset (SBAS) and the Coherent Pixel Technique (CPT) techniques have been used. Different SAR datasets have been exploited: ERS-1/2, ENVISAT, TerraSAR-X and Sentinel-1. Some GPS campaigns have been also carried out in a subsidence prone area. 3D vertices have been selected very close to existing persistent scatterers in order to link the GPS measurement results to the SAR ones. GPS data were processed into the International reference system and the comparisons between the coordinates, for the first 6 months of the monitoring, provided results with the same trend of the DInSAR data, even if inside the precision of the method