Consapevolmente intelligenti: un\u2019indagine esplorativa sull\u2019uso dei social network nella scuola primaria

I Social Network sono una preziosa occasione per costruire una societ\ue0 pi\uf9 attenta e responsabile, una pra-tica che si assimila imparando a utilizzare il Web in maniera consapevole. La competenza digitale si configu-ra come competenza alla partecipazione attiva alla Rete e alla societ\ue0. L\u2019attenzione \ue8 posta sulla necessit\ue0 di acquisire un know-how per sfruttare i media, con particolare riferimento ai Social Network, in modo intelli-gente cos\uec da farli diventare strumenti intelligenti. Dal punto di vista educativo i Social Network offrono diver-se potenzialit\ue0 in quanto: sono in grado di supportare le funzioni di socializzazione, condivisione e coordi-namento; di incoraggiare il dialogo, promuovere la condivisione di risorse e migliorare lo sviluppo di capacit\ue0 comunicative; di sostenere l\u2019apprendimento facilitando il supporto tra pari nello svolgimento dei compiti. Le criticit\ue0 maggiori derivano dal contrasto tra i modelli d\u2019impiego dei Social Network aperti nei contesti educati-vi formali e le pratiche d\u2019uso degli alunni in ambito informale. Sul tema del rapporto tra i Social Network e i processi di insegnamento/apprendimento, se da una parte si rileva l\u2019urgenza di utilizzarli per potenziare l\u2019intelligenza, per trovare le risposte pi\uf9 efficaci a problemi complessi, dall\u2019altra parte \ue8 necessario che si im-pari a farlo con consapevolezza, con senso critico, con rispetto e responsabilit\ue0. Il lavoro documenta un\u2019indagine esplorativa sull\u2019utilizzo critico e consapevole dei Social Network nella scuola primaria. L\u2019indagine, che si \ue8 svolta nel corrente anno scolastico, ha coinvolto 2399 alunni, 100 insegnanti e 50 diri-genti di 50 scuole primarie della Sicilia occidentale. La ricerca ha inteso esplorare, da una parte, se e in che modo gli alunni di classe quarta e quinta primaria utilizzano i Social Network; dall\u2019altra parte, in che modo insegnanti e dirigenti possono orientare i bambini all\u2019uso consapevole e critico dei social. Gli strumenti utiliz-zati per lo studio sono: il questionario ICRTDIG (Digital Critical Thinking and Intelligence), appositamente costruito e validato per gli alunni, e un\u2019intervista semi-strutturata per gli insegnanti e i dirigenti. I risultati la-sciano intravvedere piste di ricerca e ambiti applicativi interessanti.Social Networks are a noteworthy opportunity to build a more caring and responsible society, a practice that is assimilated by learning to use the Web in a conscious way. The media competence takes the form of ex-pertise both to active participation to the Web and to society. The focus is on the need to acquire the know-how to exploit the media, with particular reference to social networks, in a clever way so as to make them in-telligent instruments. From an educational point of view, Social Networks offer a different potential because they are able to support the functions of socialization, of sharing and of coordination; to encourage dialogue, promote resources sharing and improve the development of communication skills; to support learning by fa-cilitating peer support in the performance of tasks. The main critical issues arise from the contrast between the patterns of use of social networks in formal educational settings and their use within the informal educa-tional settings. As to the relationship between social networks and the teaching/learning processes, on the one hand, there is an urgent need to use them to increase intelligence as well as to find the most effective solutions to complex problems; on the other hand, it is necessary to learn how to do so consciously, critical-ly, with respect and responsibility. The present work documents an exploratory survey on the critical and conscious use of Social Networks at school. The survey carried out during the scholastic year 2016-2017, involved 2239 pupils, 100 teachers and 50 Head Teachers of 50 Sicily Primary schools. The research aimed to explore whether and how students actually use social networks; it explored on how future teachers and educators can guide the young towards a conscious and critical use of Social Networks. The tools used for the study are a questionnaire specially constructed and a semi-structured interview. The results reveal new avenues of research and interesting application areas

Sleep and Cognition

Sleep is an ancestral and primitive behaviour, an important part of life thought to be essential for restoration of body and mind. As adults, we spend approximately a third of our lives asleep and as we progress through life there are certain shifts in sleep architecture, most notably in sleep quantity. These biological or physiological age-dependent changes in sleep are well documented [1], and alongside the shifts in sleep architecture there is an increased susceptibility to certain sleep disorders. Sleep disturbances and sleep deprivation are common in modern society. Most studies show that since the beginning of the century, populations have been subjected to a steady constant decline in the number of hours devoted to sleep. This is due to changes in a variety of environmental and social conditions (e.g. less dependence on daylight for most activities, extended shift work and 24/7 round-the-clock activities

Estudio bacteriológico, serológico e histopatológico de lechones destetados infectados experimentalmente con Salmonella Typhimurium

In the last decades, infections by several serovars of Salmonella have become relevant worldwide, not only due to their impact on veterinary health and animal production, but also because they may serve as a source of infection for the human population. Pigs can be infected by several Salmonella serovars, being S. Typhimurium one of the most frequently isolated worldwide. In this context, the evaluation of strategies to control Salmonella in farms demands the understanding of the pathogenesis of the microorganism. Thus, the objective of this work was to carry out an experimental infection in 50-day-old pigs using a field strain of S. Typhimurium to evaluate the excretion of the microorganism, organs colonization and the development of histological injuries over the 13-day trial period. Disease was successfully reproduced in eight animals, and two clinical patterns were identified. In four animals, a primarily enteric pattern was observed, where the infection was limited to the gastrointestinal tract, while in another four pigs, enteric and systemic infection with variable fecal excretion and invasion of internal organs was observed. These two infectious patterns were accompanied by changes in fecal consistency and reduced daily weight gain or weight loss in the animals. The observation of two different infectious patterns highlights the need to consider the complexity of the pathogenicity of Salmonella Typhimurium infection in pigs.En las últimas décadas las infecciones por diferentes serovariedades de Salmonella han adquirido importancia a nivel mundial, no solo por su impacto en la sanidad y en la producción de los animales, sino también porque estos constituyen una fuente de infección para los humanos. Los cerdos pueden estar infectados o ser portadores de distintas serovariedades con potencial zoonótico, siendo S. Typhimurium una de las más frecuentemente aisladas a nivel mundial. En este contexto, la evaluación de estrategias para el control de Salmonella en granjas exige el conocimiento de la patogenia del microorganismo. El objetivo de este trabajo fue realizar una infección experimental en cerdos de 50 días de edad utilizando una cepa de campo de S. Typhimurium para evaluar la excreción del microorganismo, la colonización de órganos y el desarrollo de lesiones histológicas durante los 13 días del ensayo. Se logró reproducir la enfermedad en ocho animales y se pudo identificar dos cuadros clínicos. En cuatro animales se observó un cuadro principalmente entérico, en el que la infección estuvo limitada al tracto gastrointestinal; mientras que en otros cuatro cerdos se observó infección entérica y sistémica con excreción fecal variable e invasión de órganos internos. Estos dos cuadros infecciosos estuvieron acompañados de cambios en la consistencia de la materia fecal y menor ganancia diaria de peso o adelgazamiento de los animales. La observación de dos cuadros infecciosos diferentes muestra la necesidad de considerar la complejidad de la patogenicidad de la infección por Salmonella Typhimurium en cerdos

Implementing a 48 h EWTD-compliant rota for junior doctors in the UK does not compromise patients’ safety : assessor-blind pilot comparison

Background: There are currently no field data about the effect of implementing European Working Time Directive (EWTD)-compliant rotas in a medical setting. Surveys of doctors’ subjective opinions on shift work have not provided reliable objective data with which to evaluate its efficacy. Aim: We therefore studied the effects on patient's safety and doctors’ work-sleep patterns of implementing an EWTD-compliant 48 h work week in a single-blind intervention study carried out over a 12-week period at the University Hospitals Coventry & Warwickshire NHS Trust. We hypothesized that medical error rates would be reduced following the new rota. Methods: Nineteen junior doctors, nine studied while working an intervention schedule of <48 h per week and 10 studied while working traditional weeks of <56 h scheduled hours in medical wards. Work hours and sleep duration were recorded daily. Rate of medical errors (per 1000 patient-days), identified using an established active surveillance methodology, were compared for the Intervention and Traditional wards. Two senior physicians blinded to rota independently rated all suspected errors. Results: Average scheduled work hours were significantly lower on the intervention schedule [43.2 (SD 7.7) (range 26.0–60.0) vs. 52.4 (11.2) (30.0–77.0) h/week; P < 0.001], and there was a non-significant trend for increased total sleep time per day [7.26 (0.36) vs. 6.75 (0.40) h; P = 0.095]. During a total of 4782 patient-days involving 481 admissions, 32.7% fewer total medical errors occurred during the intervention than during the traditional rota (27.6 vs. 41.0 per 1000 patient-days, P = 0.006), including 82.6% fewer intercepted potential adverse events (1.2 vs. 6.9 per 1000 patient-days, P = 0.002) and 31.4% fewer non-intercepted potential adverse events (16.6 vs. 24.2 per 1000 patient-days, P = 0.067). Doctors reported worse educational opportunities on the intervention rota. Conclusions: Whilst concerns remain regarding reduced educational opportunities, our study supports the hypothesis that a 48 h work week coupled with targeted efforts to improve sleep hygiene improves patient safety

Hematologic toxicity of radium-223 in elderly patients with metastatic Castration Resistant Prostate Cancer: a real-life experience

Background: Treatment with radium-223 has been shown to increase survival and to delay skeletal events related to bone metastases of patients with metastatic Castration Resistant Prostate Cancer (mCRPC). This treatment has also proved to be well tolerated, and hematological toxicity, in particular anemia, represents the most represented adverse event. Materials and methods: We evaluated the hematologic toxicity of Ra-223 treatment in a real-life experience of 38 patients from two Italian cancer centers, with bone metastases from mCRPC. The main endpoint of the study was the evaluation of the efficacy and tolerability of treatment with radium-223, with greater reference to hematological toxicity (especially anemia) as the cause of interruption of treatment, specifically in the elderly patient. Results: From August 2016 to October 2017, a total of 38 consecutive nonselected patients, 20 of them aged &gt;75 years, with mCRPC symptomatic bone metastases, were enrolled for radium-223 at standard doses. Hematologic adverse events were recorded more frequently (72.4% with AE), and 36.8% had anemia. The most frequent cause of treatment discontinuation due to AEs was anemia [8/10 patients (80%)], followed by thrombocytopenia (2 patients) and neutropenia (1 patient). Hematologic AEs were more represented in elderly patients with greater disease burden and previously treated with docetaxel. Conclusions: Anemia is the most represented AE related to radium-223 treatment in elderly patients with greater disease burden and previously treated with docetaxel, besides representing the main reason for interruption of treatment. Correct patient selection, appropriate timing, and adequate supportive care are elements that could facilitate successful treatment with radium-223, preventing premature interruption of the same. The results of this experience support the opportunity to propose treatment with radium-223 mostly in patients in the earliest stages

Recurrent Endometrial Cancer: Which Is the Best Treatment? Systematic Review of the Literature

Background: Endometrial cancer is the most common gynaecological tumour in developed countries. The overall rate of relapse has remained unchanged in recent decades. Recurrences occur in approximately 20% of endometrioid and 50% of non-endometrioid cases. The aim of this systematic review is to compare different therapeutic strategies in the treatment of endometrial cancer recurrence to evaluate their prognostic and curative effects based on site and type of recurrence. Methods: This systematic review of literature was conducted in accordance with the PRISMA guidelines. The study protocol was registered on PROSPERO (CRD42020154042). PubMed, Embase, Chocrane and Cinahl databases were searched from January 1995 to September 2021. Five retrospective studies were selected. Results: A total of 3571 studies were included in the initial search. Applying the screening criteria, 299 articles were considered eligible for full-text reading, of which, after applying the exclusion criteria, 4 studies were selected for the final analysis and included in the systematic review. No studies were included for a quantitative analysis. We divided the results according to the location of the recurrence: locoregional recurrence, abdominal recurrence and extra abdominal recurrence. Conclusion: the treatment of choice should be assessed according to the relapse location and to the presence of single or multiple lesions. A crucial role in the decision-making algorithm is also the type of adjuvant treatment received at the time of the first diagnosis

Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach

<div><p>The associations between time spent in sleep, sedentary behaviors (SB) and physical activity with health are usually studied without taking into account that time is finite during the day, so time spent in each of these behaviors are codependent. Therefore, little is known about the combined effect of time spent in sleep, SB and physical activity, that together constitute a composite whole, on obesity and cardio-metabolic health markers. Cross-sectional analysis of NHANES 2005–6 cycle on N = 1937 adults, was undertaken using a compositional analysis paradigm, which accounts for this intrinsic codependence. Time spent in SB, light intensity (LIPA) and moderate to vigorous activity (MVPA) was determined from accelerometry and combined with self-reported sleep time to obtain the 24 hour time budget composition. The distribution of time spent in sleep, SB, LIPA and MVPA is significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin (all p<0.001), and systolic (p<0.001) and diastolic blood pressure (p<0.003), but not HDL or LDL. Within the composition, the strongest positive effect is found for the proportion of time spent in MVPA. Strikingly, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior are asymmetric. For example, re-allocating 10 minutes of SB to MVPA was associated with a lower waist circumference by 0.001% but if 10 minutes of MVPA is displaced by SB this was associated with a 0.84% higher waist circumference. The proportion of time spent in LIPA and SB were detrimentally associated with obesity and cardiovascular disease markers, but the association with SB was stronger. For diabetes risk markers, replacing SB with LIPA was associated with more favorable outcomes. Time spent in MVPA is an important target for intervention and preventing transfer of time from LIPA to SB might lessen the negative effects of physical inactivity.</p></div

Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

Background: Non-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared “downstream, agentic” approaches targeting individuals with “upstream, structural” policy-based population strategies. Methods: We searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from “downstream”: dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most “upstream” regulatory and fiscal interventions, and comprehensive strategies involving multiple components. Results: After screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals. Conclusions: Comprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and “upstream” population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than “downstream”, individually focussed interventions. This ‘effectiveness hierarchy’ might deserve greater emphasis in future NCD prevention strategies

Substantial lymph-vascular space invasion (Lvsi) as predictor of distant relapse and poor prognosis in low-risk early-stage endometrial cancer

Objective: The aim of this study is to analyze the prognostic role of lymph-vascular space invasion (LVSI), evaluated in a semi-quantitative fashion on prognosis of early stage, low risk endometrial cancer (EC). Methods: We enrolled patients who underwent surgery for endometrial cancer between 2003 and 2018 in two referral cancer center. All patients had endometrioid EC, G1–G2, with myometrial invasion &lt;50%, and no lymph-node involvement. LVSI was analyzed in a semi-quantitative way, according to a 3-tiered scoring system in absent, focal and substantial. Results: Among 524 patients, any positive LVSI was found in 57 patients (10.9%) with focal LVSI (n=35, 6.7%) and substantial LVSI (n=22, 4.2%). Substantial LVSI was associated to higher rate of G2 (p&lt;0.001), myometrial infiltration (p=0.002) and greater tumor dimensions (p=0.014). Patients with substantial LVSI were more likely to receive adjuvant treatment (6.6% vs. 52.6%, p&lt;0.001). The 5-year OS was 99.5% in patients with absent LVSI and 70.6% in those with substantial LVSI (p&lt;0.001). The 5-year disease free survival (DFS) was 93.6% in patients with absent LVSI and 56.5% in those with substantial LVSI (p&lt;0.001). The rate of distant failures increased from 1.8% for absent LVSI to 22.7% for substantial LVSI (p=0.002). In univariate analysis substantial LVSI was the strongest predictor of poor overall survival (hazard ratio [HR]=11.9, p=0.001). Multivariate analysis showed that substantial LVSI was an independent predictive factor of both recurrence (HR=5.88, p=0.001) and distant failure (HR=10.6, p=0.006). Conclusions: Substantial LVSI represents the strongest independent risk factor for decreased survival and distant relapse, indicating a role for potential hematogenous dissemination

Interpreting and acting upon home blood pressure readings: A qualitative study

This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Vasileiou et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Recent guidelines recognize the importance of home blood pressure monitoring (HBPM) as an adjunct to clinical measurements. We explored how people who have purchased and use a home blood pressure (BP) monitor make sense of, and act upon, readings and how they communicate with their doctor about the practice of home monitoring. Methods: A qualitative study was designed and participants were purposively recruited from several areas in England, UK. Semi-structured in-depth interviews were conducted with 18 users of home BP monitors. The transcribed data were thematically analysed. Results: Interpretation of home BP readings is complex, and is often characterised by uncertainty. People seek to assess value normality using ‘rules of thumb’, and often aim to identify the potential causes of the readings. This is done by drawing on lay models of BP function and by contextualising the readings to personal circumstances. Based on the perceived causes of the problematic readings, actions are initiated, mostly relating to changes in daily routines. Contacting the doctor was more likely when the problematic readings persisted and could not be easily explained, or when participants did not succeed in regulating their BP through their other interventions. Most users had notified their doctor of the practice of home monitoring, but medical involvement varied, with some participants reporting disinterest or reservations by doctors. Conclusions: Involvement from doctors can help people overcome difficulties and resolve uncertainties around the interpretation of home readings, and ensure that the rules of thumb are appropriate. Home monitoring can be used to strengthen the patient-clinician relationship