Study of the attitudes and future intentions of nursing students towards working with older people: an observational study

Background: Older people are increasing in the world leading to the fact that many nursing students will work in geriatric care setting. It was also reported the lack of knowledge and interest in working with older people by many nursing students. Therefore, the aim of the study is to explore the attitudes, wills, and intentions for the care of older people from nursing students. Methods: A sample of 383 students (mean age between 17 and 24; females: 76.2%) was divided according to the year. A questionnaire and three scales investigating the attitude for working with older persons (Kogan, Aday-Campbell, Nolan scales) were administered. Simple correlations across the three scales and the comparisons in means by year of graduation were reported. Results: Of the 383 students, 69.7% would take care of an older person, with the previous experience with older patients being the most important determinant in positive attitude of students in working with older people. The Kogan scale revealed a relatively positive attitude towards older people of the students involved; the Aday’s scale a reasonable willingness to take care of the older people; the Nolan scale a fair intention. Aday’s scale significantly correlated with Nolan’s scale and with Kogan’s scale as well as the Nolan scale correlated with the Kogan scale. Conclusion: Our study suggests that the quality of care provided to older people is related to the attitudes of health professionals indicating that nursing educators should adopt effective strategies to increase and promote students’ positive attitudes to older people. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG

Multi-sensor analysis of extreme events in North-Eastern Italy

International audienceThe North-eastern part of Italy is known to be one of the most rainy regions in Europe. In this paper three extreme events are analysed, using a multi-sensor observing system including a weather radar and a dense telemetric network of surface stations, recording precipitation, wind, temperature and relative humidity. The cases examined comprise two long lasting rainfall events impacting two distinct areas, and a vigorous hail-producing thunderstorm event over the plains. In all cases, inter-comparison between remotely sensed and surface observations, including estimates and measures of precipitation and wind, helps to better understand the behaviour of the atmosphere, thus supporting operational fore- and now-casting. In the case of widespread precipitation, a relation is suggested between the wind speed and direction at medium/low levels with the location of the maximum precipitation relative to the mountains. This reflects the dynamical interaction between the mountain barrier and the atmospheric flux impinging upon it. This flux can be estimated by the automatic weather station of Mt. Cesen, a focal point for a now-casting of the rain in the Veneto Region. Analysis of strong thunderstorm activity makes extensive use of radar data. In the examined case the interaction of a sea breeze-like circulation with a mesoscale trough gave rise to a distinct convergence line that triggered a severe and long-lived hail-producing multi-cell thunderstorm. The hail was successfully detected by the radar's hail detection algorithm

Intraoperative electrically auditory brainstem responses to monitor auditory functionality preservation during auditory brainstem implant application.

Background: Perceptual outcomes of individuals with neurofibromatosis type II implanted with auditory brainstem implant are poor, and many factors seem to be involved. Undoubtedly, the preservation of neural functionality is the crucial aspect. The aim of this study is to verify that the use of intraoperative electrically auditory brainstem responses can help to understand if there is neural damage related to the tumor, and / or surgery. Material and Methods: A retrospective case series analysis was performed to review data from 6 adult patients affected by neurofibromatosis type 2 who received an auditory brainstem implant. A correlation was sought between intraoperative electrophysiological data, auditory performance at 1 and 2.5 years of follow-up, and auditory brainstem implant stimulation levels. Results: Patients with a better perceptual outcomes were those with more intraoperative peaks and peaks with wider amplitudes in the electrically auditory brainstem response recordings. Conclusions: Electrically auditory brainstem responses used for auditory brainstem implant placement can be a valuable tool for monitoring the preservation of neural acoustic functionality

Prevention of vertical transmission of hepatitis B virus infection

Hepatitis B virus (HBV) is the leading cause of chronic viral hepatitis. Annually, almost two million children younger than 5 years acquire the infection, mostly through vertical or horizontal transmission in early life. Vertical transmission of HBV is a high efficacy phenomenon ranging, in the absence of any preventive interventions, from 70% to 90% for hepatitis e antigen positive mothers and from 10% to 40% for hepatitis e antigen-negative mothers. Maternal viraemia is a preeminent risk factor for vertical transmission of HBV. Maternal screening is the first step to prevent vertical transmission of HBV. Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection. Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low- and middle-income countries where the prevalence of the infection is at the highest

Treatment of multidrug-resistant and extensively drug-resistant tuberculosis in children: The role of bedaquiline and delamanid

Multidrug-resistant (MDR) tuberculosis (TB) has been emerging at an alarming rate over the last few years. It has been estimated that about 3% of all pediatric TB is MDR, meaning about 30,000 cases each year. Although most children with MDR-TB can be successfully treated, up to five years ago effective treatment was associated with a high incidence of severe adverse effects and patients with extensively drug-resistant (XDR) TB had limited treatment options and no standard regimen. The main objective of this manuscript is to discuss our present knowledge of the management of MDR-and XDR-TB in children, focusing on the characteristics and available evidence on the use of two promising new drugs: bedaquiline and delamanid. PubMed was used to search for all of the studies published up to November 2020 using key words such as “bedaquiline” and “delamanid” and “children” and “multidrug-resistant tuberculosis” and “extensively drug-resistant tuberculosis”. The search was limited to articles published in English and providing evidence-based data. Although data on pediatric population are limited and more studies are needed to confirm the efficacy and safety of bedaquiline and delamanid, their use in children with MDR-TB/XDR-TB appears to have good tolerability and efficacy. However, more evidence on these new anti-TB drugs is needed to better guide their use in children in order to design effective shorter regimens and reduce adverse effects, drug interactions, and therapeutic failure

Can i take your subdomain? Exploring same-site attacks in the modern web

Related-domain attackers control a sibling domain of their target web application, e.g., as the result of a subdomain takeover. Despite their additional power over traditional web attackers, related-domain attackers received only limited attention from the research community. In this paper we define and quantify for the first time the threats that related-domain attackers pose to web application security. In particular, we first clarify the capabilities that related-domain attackers can acquire through different attack vectors, showing that different instances of the related-domain attacker concept are worth attention. We then study how these capabilities can be abused to compromise web application security by focusing on different angles, including cookies, CSP, CORS, postMessage, and domain relaxation. By building on this framework, we report on a large-scale security measurement on the top 50k domains from the Tranco list that led to the discovery of vulnerabilities in 887 sites, where we quantified the threats posed by related-domain attackers to popular web applications

Cost-effectiveness of buffered soluble alendronate 70 mg effervescent tablet for the treatment of postmenopausal women with osteoporosis in Italy

Summary: The use of buffered soluble alendronate 70 mg effervescent tablet, a convenient dosing regimen for bisphosphonate therapy, seems a cost-effective strategy compared with relevant alternative treatments for postmenopausal women with osteoporosis aged 60 years and over in Italy. Introduction: To assess the cost-effectiveness of buffered soluble alendronate (ALN) 70 mg effervescent tablet compared with relevant alternative treatments for postmenopausal osteoporotic women in Italy. Methods: A previously validated Markov microsimulation model was adjusted to the Italian healthcare setting to estimate the lifetime costs (expressed in €2019) per quality-adjusted life-years (QALY) of buffered soluble ALN compared with generic ALN, denosumab, zoledronic acid and no treatment. Pooled efficacy data derived from the NICE network meta-analysis were used for bisphosphonate treatments. Two treatment duration scenarios were assessed: 1 year using persistence data derived from an Italian prospective observational study including 144 and 216 postmenopausal osteoporotic women on buffered soluble ALN and oral ALN, respectively, and 3 years. Analyses were conducted for women 60–80 years of age with a bone mineral density T-score ≤ − 3.0 or with existing vertebral fractures. Results: In all simulated populations, buffered soluble ALN was dominant (more QALYs, lower costs) compared to denosumab. The cost per QALY gained of buffered soluble ALN compared to generic ALN and no treatment always falls below €20,000 per QALY gained. In the 1-year treatment scenario, zoledronic acid was associated with more QALY than buffered soluble ALN but the cost per QALY gained of zoledronic acid compared with buffered soluble ALN was always higher than €70,000, while buffered soluble ALN was dominant in the 3-year treatment scenario. Conclusion: This study suggests that buffered soluble ALN represents a cost-effective strategy compared with relevant alternative treatments for postmenopausal osteoporosis women in Italy aged 60 years and over. © 2021, The Author(s)

Correlated Electrons Step-by-Step: Itinerant-to-Localized Transition of Fe Impurities in Free-Electron Metal Hosts

High-resolution photoemission spectroscopy and realistic ab-initio calculations have been employed to analyze the onset and progression of d-sp hybridization in Fe impurities deposited on alkali metal films. The interplay between delocalization, mediated by the free-electron environment, and Coulomb interaction among d-electrons gives rise to complex electronic configurations. The multiplet structure of a single Fe atom evolves and gradually dissolves into a quasiparticle peak near the Fermi level with increasing the host electron density. The effective multi-orbital impurity problem within the exact diagonalization scheme describes the whole range of hybridizations.Comment: 10 pages, 4 figure

Multidimensional prognostic index and mortality in intermediate care facilities: A retrospective study

Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in older patients admitted to the ICFs. MPI was calculated using different domains explored by a standard comprehensive geriatric assessment and categorized into tertiles (MPI-1 ≤ 0.20, MPI 2 0.20–0.34, MPI 3 > 0.34). A Cox’s regression analysis, taking mortality as the outcome, was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). In total, 653 older patients were enrolled (mean age: 82 years, 59.1% females). Patients in MPI-2 (HR = 3.66; 95%CI: 2.45–5.47) and MPI-3 (HR = 6.22; 95%CI: 4.22–9.16) experienced a higher risk of mortality, compared to MPI-1. The accuracy of MPI in predicting mortality was good (area under the curve (AUC) = 0.74, 95%CI: 0.70–0.78). In conclusion, our study showed that prognostic stratification, as assessed by the MPI, was associated with a significantly different risk of mortality in older patients admitted to the ICFs, indicating the necessity of using a CGA-based tool for better managing older people in this setting as well. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Oxidative Stress Markers to Investigate the Effects of Hyperoxia in Anesthesia

Oxygen (O-2) is commonly used in clinical practice to prevent or treat hypoxia, but if used in excess (hyperoxia), it may act as toxic. O-2 toxicity arises from the enhanced formation of Reactive Oxygen Species (ROS) that exceed the antioxidant defenses and generate oxidative stress. In this study, we aimed at assessing whether an elevated fraction of inspired oxygen (FiO(2)) during and after general anesthesia may contribute to the unbalancing of the pro-oxidant/antioxidant equilibrium. We measured five oxidative stress biomarkers in blood samples from patients undergoing elective abdominal surgery, randomly assigned to FiO(2) = 0.40 vs. 0.80: hydroperoxides, antioxidants, nitrates and nitrites (NOx), malondialdehyde (MDA), and glutathionyl hemoglobin (HbSSG). The MDA concentration was significantly higher 24 h after surgery, and the body antioxidant defense lower, in the FiO(2) = 0.80 group with respect to both the FiO(2) = 0.40 group and the baseline values (p <= 0.05, Student's t-test). HbSSG in red blood cells was also higher in the FiO(2) = 0.80 group at the end of the surgery. NOx was higher in the FiO(2) = 0.80 group than the FiO(2) = 0.40 group at t = 2 h after surgery. MDA, the main end product of the peroxidation of polyunsaturated fatty acids directly influenced by FiO(2), may represent the best marker to assess the pro-oxidant/antioxidant equilibrium after surgery