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We conducted a study on a local scale targeting the relationship of economic capital, cultural capital, young people's literacy, numeracy achievements, and the school-to-work transition. We investigated whether participation rates by very young children in early childhood education (ECE) may mediate the historical effects of economic and cultural capital. We analysed longitudinal data from a high-quality national database that included information from 103 Italian provinces. We used structural equation modelling (SEM), multi-sample SEM to investigate spatial inequalities, and mediation analyses. Vector Autoregression models were estimated to determine the temporal trend and the relationship occurring between economic capital and ECE. Results indicate that economic capital is associated with young people's literacy and numeracy achievements and with the NEET rate, with only partial mediation played by the rate of participation in ECE. The association of cultural capital on the NEET rate is near to significance, but it is strongly mediated by participation in ECE. Together, these results imply that the rate of participation in ECE in the Italian provinces may mediate the effect of cultural capital, but only partly that of economic capital.

Critical reflexivity has been acknowledged as fundamental in higher education. For facing complex situations in turbulent environments, students nowadays need not only to be taught technical knowledge, but also to be helped develop "relevant" learning for their future professional practice. In recent years, scholars have concentrated on what makes the internship experience a successful opportunity for the parties involved, and have also discussed the crucial role of a mentor/tutor in sustaining relevant and effective learning. However, the specific conditions that make tutorship successful in promoting critical reflexivity in such a boundary crossing experience need to be further explored. Aim of this paper is therefore to analyze what tutorship conditions sustain the development of critical reflexivity in internship. For this purpose, we will present the case study of an internship program run by one of the largest universities in northern Italy.

Purpose: The purpose of this paper is to explore the enactment of safety routines in a transshipment port. Research on work safety and reliability has largely neglected the role of the workers' knowledge in practice in the enactment of organisational safety. The workers' lack of compliance with safety regulations represents an enduring problem that often involves first-level managers, who are willing to turn a blind eye toward divergent practices. The CHAT conceptual vocabulary and theoretical model is used to explore this issue. Design/methodology/approach: A grounded, empirical study in a large transshipment port in the Mediterranean area is conducted. Ethnographic methods including participant observation and interviews are used, and emerging data are analyzed through an interpretive methodology. The paper explores 30 employees' narrated accounts of how safety rules are enacted or infringed while living and working in the field in a transshipment port. Data obtained through organisational shadowing provided secondary data. Interview data were analyzed using content analysis, using a CHAT framework. Constant comparison and theoretical sensitivity were pursued through an iterative analysis process. Findings: This study documented the critical role the workers' knowledge played in practice in ensuring the efficient functioning of the port, and evidenced that the disconnect between safety procedures and technical productivity standards is the most important factor determining the erratic compliance with prescribed procedures. The selective application of safety norms was deliberate in nature, collectively shared and culturally regulated. Research limitations/implications: This contribution fails to address probably the most important aspect of the activity theoretical approach: its developmental orientation. The initial analysis intervention was meant to lead to a longitudinal process of expansive learning and development in the activity system. The authors had planned to initiate a cycle of expansive learning laboratories involving representatives of the dockworkers, the port management and the safety certification firm, but this had to be postponed to an undefined time due to the significant changes occurred in the international maritime cargo industry and the decision of the multinational company who owns the transshipment port to cut down its cargo traffic and privilege other ports in the Mediterranean area. Practical implications: The practical implications of the case study concern the conception and design of safety training and management for the port organisation. By acknowledging the disconnect between espoused safety routines and the constraints and affordances of the workers' everyday work practice, it is suggested that safety training could be more effective if it engaged the workers (or first-level supervisors) in the fine tuning of safety regulations. Workplace learning opportunities could enable the workers to learn and construct situated safety practices. Social implications: This paper seeks to highlight how the consideration of local knowledge and context-dependent practices can achieve better comprehension of situated application of safety norms. Originality/value: The paper contributes to understanding the complexity of enacting and translating safety procedures into everyday work practices.

Antiretroviral therapy (ART) significantly reduced Human Immunodeficiency Virus (HIV) morbidity and mortality; nevertheless, stigma still characterises the living with this condition. This study explored patients' coping experience by integrating narrative medicine (NM) in a non-interventional clinical trial. From June 2018 to September 2020 the study involved 18 centres across Italy; enrolled patients were both D/C/F/TAF naïve and previously ART-treated. Narratives were collected at enrolment (V1) and last visit (V4) and then independently analysed by three NM specialist researchers through content analysis. One-hundred and fourteen patients completed both V1 and V4 narratives. Supportive relationships with clinicians and undetectable viral load facilitated coping. Conversely, lack of disclosure of HIV-positive status, HIV metaphors, and unwillingness to narrate the life before the diagnosis indicated internalised stigma. This is the first non-interventional study to include narratives as patient reported outcomes (PROs). Improving HIV awareness and reducing the sense of guilt experienced by patients helps to overcome stigma and foster coping. [ABSTRACT FROM AUTHOR]

In spring 2021, 50 growing steers and heifers of the Maremmana breed (average age 321 d and weight 287 kg) were rotationally stocked under two different treatments (silvopastoral and pastoral). The aim was to evaluate the influence of grazing system on cattle growth and welfare, and pasture depletion. The experiment was carried out on a real Mediterranean agrosilvopastoral farm, located in central Italy. To implement rotational grazing, 3.69 ha of temporary grassland were split into six paddocks, three for each treatment. Cattle grazed for one week in one paddock and then were moved to the next one for a total of six weeks corresponding to six grazing periods. The group maintained on the silvopastoral system were allowed to access 3.31 ha of a Turkey oak (Quercus cerris L.) forest. Regarding the average daily gain, a significant interaction was found between the treatment and time. The average daily gain of the animals grazing in the open pasture was 1.20 kg d−1, while that of the cattle grazing in the silvopastoral system was 1.02 kg d−1. Despite the rate of growth being within the expected range for the Maremmana breed, the average daily gain of cattle in the silvopastoral system was significantly lower. One of the possible causes of this difference could be the higher energy requirements of the animals due to the different activity levels. The different management did not affect animal welfare indicators. Indeed, the serum cortisol concentration did not vary between treatments and among sampling times, while the hair cortisol concentration decreased significantly during the experiment for both groups. Regarding pasture health, allowing cattle to graze in the forest reduced pasture depletion because of the lower stocking rate and grazing pressure. Further studies are necessary to increase the knowledge of the role of forests and grazing management in other seasons than spring in extensive agrosilvopastoral systems. [ABSTRACT FROM AUTHOR]

Purpose: This paper seeks to provoke thoughts around the possibility of using the lever of practices and situated knowledge to trigger organisational change and to redesign it with the involvement of the whole organisation. Design/methodology/approach: The paper presents connections between a psychosociological approach and a practice-based approach. The use of ethnomethodology is offered as a way to detect situated practice and meaning at works. Findings: This contribution underlines how change and learning in organisations can find support in investing in local knowledge and in detecting and reflecting around the living practices of daily activities. Knowing in practice requires the involvement and continuous work of connecting among individuals, groups, organisations and institutions in situated contexts. The paper shows how strategic a process this is, presenting a way to work on situated data. Practical implications: The paper represents a way to work on organisational change grounded on action research. Originality/value: The paper combines a psychological perspective within the field of practice-based studies and sustains a specific ethnographic method to create organisational areas of reflexivity. (Contains 1 table.)

Investigates how the age of entry into regular group day care influences short-term behaviors expressing well-being or discomfort in the day care environment. Finds that children entered at two particular ages displayed difficult reunions with their mothers and were less resistant to frustration; children entered at another age showed lower relational distress. (DSK)

Rett syndrome (RTT) is a severe neurodevelopmental disorder resulting in a wide range of functional impairments and therefore greatly impacts the lives of both patients and their families. While genetic and medical aspects have been studied for several decades, rehabilitation intervention research is still in its infancy. In this study, the investigating researchers have presented a rehabilitative framework by using music therapy for girls with RTT. This model is founded upon the use of music therapy in light of Stern's proposal of subjective experience and affect attunement; it also refers to Rosenbaum's family-centered rehabilitation medicine perspective. This study both describes the theory behind this intervention and presents a newly developed outcome measure. This novel tool may have future clinical and research applications. Music therapy for patients with RTT has not been well researched yet, and, as a result, is not universally recommended. However this study's findings suggest that music therapy is an important component of multidisciplinary therapy. Further collaborative research should be encouraged in order to study and implement the use of music therapy in the treatment of severe disabilities. Projects such as the Enablin+ program with the support from the European Commission constitute fundamental tools in promoting integrative medical research and international networks. [ABSTRACT FROM AUTHOR]

The pandemic period has placed the organizations in a state of great tension. It has generated a situation of confusion, lack of rules, and production-related criticalities that have called into question the very existence of many productive realities. This article aims to highlight the dimensions of care and ethics put in place by HR managers in COVID-19. The objective that animated the authors have focused on the HRM level of medium and large companies in Italy to highlight the protective actions toward people and the organization in the period COVID 19, highlighting what were the ethical values and actions of care put in place. In this article, we wanted to give voice to managers (N = 45, including 21 women and 24 men, aged between 40 and 55 years old) who had management tasks in their organizations by asking them to tell us how they dealt with the challenges imposed by the emergency. In the research, we start from a way of understanding workplaces understood as a "process of ongoing social relationship" within which the HR function is dedicated to the care of the quality of relationships. HR managers have to manage a complex role of mediating between the interests of people and employers by trying to find good mediations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore how a nutritional intervention that improves the biochemical and functional profile of dysphagic older people impacts on nursing workload and costs for nursing homes. Background: Dysphagic institutionalized older people particularly at risk of malnutrition require more intensive support from nursing staff and higher costs for nursing homes. Method: This is an open pre–post longitudinal multicentre quasi‐experimental study without a control group. Results: There is a significant reduction in the number of enemas (from 3.51 to 1.11 enemas), with an average nursing workload reduction from 52 to 16 min per patient every month. Each nurse also spent 20 h less per patient every month spoon‐feeding. This resulted in nursing staff cost savings. Conclusions: The nutritional intervention led to a significantly better quality of life for the patients manifested through increased independence and social engagement. This reduced workload for nursing staff and costs for nursing home administrators. Implications for Nursing Management: Sensitive, targeted nutritional interventions have the potential to improve nursing home residents' quality of life and enable a more efficient use of resources. This study revealed reduced workload and cost savings due to less time spent administering enemas and spoon‐feeding, in addition to reduced malnutritional consequences. [ABSTRACT FROM AUTHOR]

The aim of this work was to evaluate the susceptibility to flavescence dorée (FD) of 12 Vitis vinifera cultivars grown in Piedmont, and representative of the wine‐making tradition of this area. The experiments were conducted under controlled conditions to ensure constant infection pressure. Test plants were ex vitro potted vines, singly inoculated with four Scaphoideus titanus infected by FD‐C phytoplasma (FDp), under greenhouse conditions. Vines were tested for FDp at 5 and 8 weeks postinoculation (wpi) and the phytoplasma load was measured in leaves and roots at 8 wpi. Within the 14 V. vinifera accessions (belonging to 12 cultivars), three susceptibility clusters were identified. Cultivars within the low susceptibility group showed low phytoplasma loads and low percentages of infected plants, suggesting a tolerant behaviour. To confirm these results, four Vitis cultivars, representing extremes of FD susceptibility from low to high, were grafted onto Kober 5BB rootstocks and inoculated with laboratory‐infected S. titanus, under semi‐field conditions. The transmission experiments onto grafted cuttings confirmed that susceptibility to the disease depends on the scion genotype. The data indicated that none of the tested V. vinifera genotypes are resistant to FD, although some cultivars with low susceptibility are available, and can be explored for identifying genetic traits involved in disease tolerance/resistance. Moreover, ranking Vitis genotypes for their susceptibility to FD is in itself a valuable tool to support vine growers in their decision management, by helping them to choose the most appropriate varieties according to their specific FD epidemiological contexts. [ABSTRACT FROM AUTHOR]

This paper focuses on how trade unions are redefining their organizational identity in response to the neoliberal changes that have affected the labour market, mainly as a result of the Global Financial Crisis of 2008. Such changes brought about a profound crisis of representation among workers in various sectors. Trade unions have had to redesign their identities to meet new demands from workers. Based on 30 interviews with unionists from one of Italy's major unions, the study identifies four discursive variations and as many potential evolutions in the identity of trade unions. The respective positionings generated by these four discourses for the union and its members are examined. The study also highlights certain contradictions in these discursive variations, which may either encourage a redefinition of the union's strategic objectives or, on the contrary, act as regulating mechanism that hampers change. [ABSTRACT FROM AUTHOR]

This paper explores how some Italian HR managers narrate the changes imposed by the COVID-19 threat in the workplace. Events since December 2019 have presented exceptional circumstances to which HR managers have reacted in very different ways. This study explored how HR managers came to introduce organizational changes aimed at coping with the emergency, as well as how employees were involved in those organizational changes. The article is based on a thematic analysis of some interviews with Italian HR managers whose companies decided to switch working from home on a massive scale. We wanted to offer some reflections on the actions taken by a few HR managers and Italian companies to keep working at a time when most workers were forced to respect the lockdown. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the factors that can influence an incomplete viral response (IVR) after acute and early HIV infection (AEHI). Methods: This was a retrospective, observational study including patients with AEHI (Fiebig stages I–V) diagnosed between January 2008 and December 2014 at 20 Italian centres. IVR was defined by: (1) viral blip (51–1000 HIV‐1 RNA copies/mL after achievement of < 50 HIV‐1 RNA copies/mL); (2) virologic failure [> 1000 copies/mL after achievement of < 200 copies/mL, or ≥ 200 copies/mL after 24 weeks on an antiretroviral therapy (ART)]; (3) suboptimal viral response (> 50 copies/mL after 48 weeks on ART or two consecutive HIV‐1 RNA levels with ascending trend during ART). Cox regression analysis was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for IVR. Results: In all, 263 patients were studied, 227 (86%) males, with a median [interquartile range (IQR)] age of 38 (30–46) years. During a median follow‐up of 13.0 (5.7–31.1) months, 38 (14.4%) had IVR. The presence of central nervous system (CNS) symptoms was linked to a higher risk of IVR (HR = 4.70, 95% CI: 1.56–14.17), while a higher CD4/CD8 cell count ratio (HR = 0.13, 95% CI: 0.03–0.51 for each point increase) and first‐line ART with three‐drug regimens recommended by current guidelines (HR = 0.40, 95% CI: 0.18–0.91 compared with other regimens including four or five drugs, older drugs or non‐standard backbones) were protective against IVR. Conclusions: Patients with lower CD4/CD8 ratio and CNS symptoms could be at a higher risk of IVR after AEHI. The use of recommended ART may be relevant for improving short‐term viral efficacy in this group of patients. [ABSTRACT FROM AUTHOR]

This article provides a description of the presence of qualitative research in Italian social and organisational psychology. The first section of the article identifies three major phases of qualitative methods and the factors that, from the 1990s, played a major role in their development: the legitimisation of qualitative research in sociology, the rising of theoretical perspectives expressing a critical stance toward the hegemonic quantitative and experimental approach of the discipline, and the demand for qualitative studies from public and private clients. In the second section, we present a review of the scientific articles published in the last five years. Our analysis shows that the health field stands out as having the greatest number of publications, both for social and organizational psychology; the absolute prevalence of the interview as a data collection method; and that Grounded theory, Discourse analysis, and Conversation analysis are the most cited references for data analysis. We discuss these results in relation to the set of rules that regulates the careers of researchers in Italy (and abroad), and to the only partial acceptance of qualitative research in Italian psychology. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study is to investigate the meaning that cancer patients in active therapy and/or rehabilitation give to their illness and resources they rely on to build new experiences of meaning and a future perspective.Methods: The present study consisted in a summative content analysis of answers to open questions of the Purpose In Life (PIL) Questionnaire administered to 158 consecutive patients with non-advanced cancer (no metastases). The PIL is an attitude scale that indicates the degree of attainment of meaning and purpose in life and is divided into three sections: a first 20-item quantitative section, with statements rated on a 7-point verbal scale with two anchoring phrases (part A); a qualitative section with 13 open-end items and paragraph composition section addressing the future goals (part B) and past meaningful experience (part C). For the present study, we analyzed the answers to open questions, most interesting in a therapeutic contest related to the meanings associated with life, illness, and suffering to understand the experienced of the cancer patients.Results: The main recurring themes in PIL section B analyzed associated to the sense of life, disease, and death are as follows: meaning (positive/negative), personal dimension, religiousness; physical health, family, normal life; negative sense of death, the end, natural transition, religious belief, consolation, mystery, rejection; opportunity, negativity. Whereas main themes emerging from section C were associated to life goals of the interviewed patients: the desire of realization in the future perspective; the value of life; physical health and healing; guiding values; plus three more themes, distinguishable, but with a minor recurrence: legacy responsibility, religiousness, lack of purpose/resignation.Conclusion: The use of summative content analysis evidenced the recurrence of a strong sense of positivity, present in the majority of the interviews. In particular, this positivity is shown by the use of words associated frequently to self-consciousness and self-evaluation, desire of happiness, and desire of contributing to the good of significant others and of taking care of your own life in order to give a positive contribution. [ABSTRACT FROM AUTHOR]

Background: Fatigue is one of the most distressing symptoms of cancer patients. Its characteristics and impact on quality of life have not been fully explored and treatment of cancer-related fatigue in Italian oncological centers has not been codified.Methods: A cross-sectional study was carried out on all patients attending for any reason the 24 participating centers in two non-consecutive days. Patients with fatigue filled out the Brief Fatigue Inventory (BFI) questionnaire and reported any pharmacological or non-pharmacological treatment for fatigue.Results: From October 2014 to May 2015, 1394 cancer patients agreed to participate in the study. Fatigue was referred by 866 (62.1%) of patients; its duration was > 4 months in 441 patients (50.9%). In the investigators' opinion, the most important (probable or almost sure) determinants of fatigue were reduced physical activity (271 patients), anxiety (149), pain (131), insomnia (125), anemia (123), and depression (123). Fatigue of moderate/severe intensity was reported by 43%/29.2% of patients, while usual fatigue in the last 24 h by 45%/33.1%, and the worst fatigue in the last 24 h by 33%/54.8%, respectively. Concerning the impact on quality of life, fatigue interfered moderately/severely with general activity in 30.8%/38.6% of patients, with mood in 26.1%/32.8%, with the ability to work in 27.9%/35.6%, with normal work in 26.7%/38.9%, with relationships with others in 21%/23.4% and with the ability to amuse themselves in 22.2%/33.1%. Only 117/866 patients (13.5%) received a pharmacological treatment represented by a corticosteroid in 101 patients (86.3%) while 188 patients (21.7%) received a non-pharmacological treatment such as physical exercise (120 patients, 63.8%) and various alimentary supplements (52 patients, 27.6%).Conclusions: Cancer-related fatigue is frequently reported by oncological patients; its intensity and impact on quality of life is relevant. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of institutionalised older people in Italy. Background Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population. Design A pre-post study without a control group. Methods The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food programme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size. Results The total mean body mass index of our sample passed from 17.88-19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemical profiles. There was a progressive improvement of total protein and serum albumin values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported. Conclusion The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people. Relevance to clinical practice The introduction of a balanced nutritional programme, using high-quality natural ingredients, appropriate texture and palatability can significantly improve health and quality of life in dysphagic older people. [ABSTRACT FROM AUTHOR]

Background: 'Living with IPF and an exploration of Esbriet® - a new treatment' was an exploratory, qualitative, real-world survey of European patients with idiopathic pulmonary fibrosis (IPF) who were receiving treatment with pirfenidone prior to its commercial availability. The aim of the survey was to probe the impact of IPF on patients' quality of life; the role of healthcare professionals and caregivers; the information needs of both patients and their caregivers; and patients' perceptions of pirfenidone as a new treatment option for IPF.Methods: Patients from the UK, Germany and Italy, with a diagnosis of IPF (duration >3 months), who were being treated with pirfenidone, were recruited from patient support groups, specialist centres and advocacy groups. Semi-structured, qualitative, in-depth patient interviews of 1-h duration were conducted by an independent researcher. Patients were initially asked about their experiences of living with IPF and then prompted to describe their experiences of taking pirfenidone. Techniques utilised included: the bubble-speech technique; the icon cards projective exercise; and the free association exercise. All interviews were transcribed and analysed by an independent researcher.Results: Forty-five patients (71% male) were interviewed (mean age 68.5 years; mean time since diagnosis 3.5 years); 87% of patients reported that diagnosis took >1 year. Patients reported that IPF had a significant physical and emotional impact on their quality of life. The beneficial role played by caregivers and interstitial lung disease specialist nurses (where available) was specifically highlighted. Although most patients were keen for information on IPF, this was often of poor quality, out of date, or in English only. Patients' perceptions of pirfenidone were largely positive and associated with 'hope' but were also influenced by the level of side effects experienced.Conclusions: This survey highlights the impact of IPF on patients' lives, and the need to adequately support both patients and their caregivers. These findings demonstrate the value of seeking patients' perspectives of a chronic disease such as IPF and how this information can be used to guide improvements in care, to best support the needs of patients with this devastating condition. [ABSTRACT FROM AUTHOR]

The word superiority effect (WSE) has made it possible to demonstrate the automatic activation of lexical-orthographic entries in reading. The observation of this effect is important since it led to experimental support of the main cognitive reading models. These models were mostly developed on English data, hence the verification in different orthography systems is relevant. The present study tested WSE in Italian, a language in which this effect was predicted to be less constant given the highly consistent correspondence between orthography and phonology. Moreover, the presentation of the items in a lateralized visual field condition allowed testing of assumptions about the roles of the right and left hemispheres in written word recognition and, in particular, on the hemispheric lateralization of lexical processing. Two experiments were conducted with undergraduate students who had to recognize a target letter within a word, pseudoword, or nonword. In Experiment 1, prime and probe letters were in the same letter case, while in Experiment 2 they were in different letter cases. Error rates and reaction times were analyzed with mixed models. The results showed a superiority of pseudowords (pseudoword superiority effect; PSE) over illegal strings with no evidence of a clear superiority of words over pseudowords for both left and right visual field presentations. This suggests that in Italian, the sub-lexical route could play a major role in reading and that this route relies on a visual-perceptual orthographic coding concerning familiarity of letter combinations, which is also available to the right hemisphere. [ABSTRACT FROM AUTHOR]

Background: Cancer-related pain continues to be a major healthcare issue worldwide. Despite the availability of effective analgesic drugs, published guidelines and educational programs for Health Care Professionals (HCPs) the symptom is still under-diagnosed and its treatment is not appropriate in many patients. The objective of the study is to evaluate the efficacy of the Pac-IFicO programme in improving the quality of pain management in hospitalised cancer patients. Methods/design: This is a before-after cluster phase II study. After the before assessment, the experimental Intervention--the Pac-IFicO programme--will be implemented in ten medicine, oncology and respiratory disease hospital wards. The same assessment will be repeated after the completion of the intervention. The Pac-IFicO programme is a complex intervention with multiple components. It includes focus group with ward professionals for identifying possible local obstacles to optimal pain control, informative material for the patients, an educational program performed through guides from the wards, and an organisational intervention to the ward. The primary end-point of the study is the proportion of cancer patients with severe pain. Secondary end-points include opioids administered in the wards, knowledge in pain management, and quality of pain management. We plan to recruit about 500 cancer patients. This sample size should be sufficient, after appropriate statistical adjustments for clustering, to detect an absolute decrease in the primary end-point from 20% to 9%. Discussion: This trial is aimed at exploring with an experimental approach the efficacy of a new quality improvement educational intervention. [ABSTRACT FROM AUTHOR]

A total of 8 lots of vacuum-packed bovine rump hearts ( Gluteus medius muscle) imported in Italy from Argentina were submitted to microbiological (total bacterial count, Enterobacteriaceae, Pseudomonas spp., Lactobacilli, sulfite-reducing Clostridia, Listeria monocytogenes) and physicochemical analyses ( pH, total volatile basic nitrogen, color measurement and shear force) after different storage times (35, 75 and 100 days). Lactobacilli were the predominant microbial population (about 6 log cfu/cm2), causing a microbial stabilization and acidification of meat. Seventy-three Lactobacilli isolates were submitted to random amplified polymorphic DNA-polymerase chain reaction and identified, showing a high prevalence of Lactobacillus sakei (in all the samples) and Lactobacillus curvatus (in samples stored for 75 or 100 days). We observed high total volatile basic nitrogen levels (>27 mgN/100 g) in all the samples and a discoloration of beef after the opening of the packs. Our results suggest the need for a higher standardization of production conditions. Practical Applications Vacuum-packed raw beef from Argentina is globally commercialized, and it is frequently shipped to European markets. Considering the perishability of this product and the very long shelf life assigned, the availability of microbiological and physicochemical data could be useful for quality evaluations purposes. Our data indicate that a long shelf life (3-4 months) is potentially achievable, but the application of the best hygienic practices during meat production and an optimal stabilization of microflora by the selection (or addition) of lactic acid bacteria must be assured. As protein degradation and microbial population showed to be stable during the shelf life, quality characteristics that are perceived by the consumer (such as color indexes) become important parameters for a proper evaluation of meat quality. [ABSTRACT FROM AUTHOR]

Objective: The first instruments developed to evaluate specific logotherapeutic dimensions were the Purpose In Life (PIL) and the Seeking Of Noetic Goals (SONG) tests, designed to reflect Frankl's concepts of, respectively, meaning in life attainment and will to meaning. This study aims to perform the Italian cultural adaptation and the psychometric validation of the PIL and SONG questionnaires. Methods: We administered the PIL and SONG, culturally adapted into the Italian language, to 266 cancer patients. The psychometric validation appraised construct validity, internal consistency, test-retest reliability, known-group validity, and convergent validity of the two questionnaires with respect to one another. Results: The factorial analysis indicates that the original single-factor solution can be maintained for both instruments (proportion of variance explained by the first factor 77% and 71% for the PIL and SONG, respectively). The results show excellent internal consistency (Cronbach's alpha of 0.91 for the PIL and 0.90 for the SONG) and test-retest reliability (intraclass correlation coefficient of 0.92 for the PIL and 0.81 for the SONG). As expected, males, believers, patients nearer to the diagnosis, and patients not undergoing psychological therapy have higher PIL and lower SONG scores, while expectations for age were not confirmed. The average level for the PIL was 107.3, while for the SONG, it was 66.1, and a negative correlation (−0.47) between PIL and SONG scores indicates good convergent validity of the two instruments. Conclusion: Italian versions of the PIL and SONG are adequate and reliable self-report instruments for evaluating purpose in life and the motivation to find purpose for cancer patient populations. [ABSTRACT FROM AUTHOR]

Stepwise multiple regression analyses were applied to 50 raltegravir pharmacokinetic profiles from 50 HIV patients with the goal to identify limited sampling strategies for the prediction of drug area under the time–concentration curve (AUC0-12). Raltegravir single sampling point-based equations failed to reliably predict daily drug exposure. Conversely, different algorithms based on few samples and associated with good correlation, acceptable bias, and imprecision with the measured raltegravir AUC0-12 were identified. These models could used to predict raltegravir exposure for clinic or research purposes. [ABSTRACT FROM PUBLISHER]

Objective: We aimed to examine the clinical outcome in HIV-1-infected patients after more than 10 years of highly active antiretroviral therapy (HAART). Methods: We analyzed data from 1,236 treatment-naïve adults who had started HAART. The primary endpoint was the yearly prevalence of death for AIDS-related causes (ARC) or for non-AIDS related causes (non-ARC). The data from our cohort were compared with that of the general population (GP) of our region. Results: We observed that 116 patients died, and 58.6% of deaths were non-ARC. The death incidence decreased from 18.8% in 1998-1999 to 1.2% in 2008-2009. The leading causes of death were malignancies (35.3%), infections (21.6%), end-stage liver diseases (18.1%), and cardiovascular diseases (CVD) (6.9%). Yearly death rates were similar in the HIV-infected cohort and in the crude GP (odds ratio [OR] 1.1, 95% confidence interval [CI] 0.5-2.5), but when adjusted for age, HIV-infected patients showed a greater risk (OR 7.4, 95% CI 4.1-13.4). The difference was still highly significant when the analysis was restricted to non-ARCs (OR 4.3, 95% CI 2.07-9.2). Overall, malignancies (OR 5.7, 95% CI 2.6-12.8) and end-stage liver diseases (OR 35.0, 95% CI 15.5-78.8) were significantly more frequent than in the age-adjusted GP. Conclusions: Despite HAART, HIV-infected patients are at greater risk of death compared to a reference uninfected population. [ABSTRACT FROM AUTHOR]

Patients with cancer frequently use dietary supplementation and herbal therapies to control symptoms of disease and adverse effects of cancer therapy. Despite the widespread use of dietary supplementation and herbal therapies in oncology, robust scientific evidence in this area is lacking. Not only do these products need to be tested in large and well-designed observational or randomized studies, but their manufacturing process must be improved to achieve higher levels of standardization in product quality. Ginger is frequently used to counteract chemotherapy-induced nausea and vomiting (CINV), and some suggestions that it might be effective against CINV come from randomized and/or crossover clinical trials. However, several limitations in the methods of these studies limit their power and generalizability. The authors are conducting a randomized, double-blind study with a large sample size and homogeneous inclusion criteria in order to evaluate the efficacy of a wellstandardized ginger extract in reducing nausea in patients with cancer. The widespread use of standardized herbal therapies and natural components among patients requires that scientific and rigorous research strategies are applied in this field to guide the physicians and the patients in safer use. [ABSTRACT FROM AUTHOR]

Fourteen vacuum packed cold smoked salmon products of different origin purchased in Italian retail were analysed at about half shelf-life (HSL) and at the expiry date (ED). On ED, eight on fourteen samples had concentration of total volatile basic nitrogen (TVBN) indicating spoilage (values >40 mg N/100 g and up to 71.3 mg N/100 g) and only five samples were not rancid (thiobarbituric acid reactive substances, TBARS <8 nmol/g). Total psychrotrophic count (TPC) at HSL was acceptable (<106 CFU/g) in most samples; at ED, in 13 samples, TPC was very high (range 1.2 × 106– 6.0 × 108 CFU/g) and Lactobacilli were the most representative bacteria. No pathogens were detected. Significant negative differences in declared weight (over 8%) were determined in nine samples. The two months shelf-life attributed to smoked salmon marketed in Italy proved to be, generally, too long and the consumer is at risk to buy a product in early stage of spoilage. [ABSTRACT FROM AUTHOR]

Background: This study estimates prevalence, management, and relief of pain during the last 3 months of life of a representative sample of dying cancer patients in Italy. [ABSTRACT FROM PUBLISHER]

Canine angiostrongylosis by Angiostrongylus vasorum is increasingly reported in both enzootic and previously free areas. The complex pathogenesis of the disease makes the clinical workup challenging. Infected dogs show highly variable clinical pictures, characterized by subclinical to life-threatening general, cardio-respiratory, neurological and/or gastrointestinal signs. The present study reports the high variability of clinical pictures from 36 dogs across central and southern Italy that were naturally infected by A. vasorum. Of them, 23 (63.9%) presented at least one clinical sign, while 13 (36.1%) were subclinically infected and apparently healthy. Overall, 19 dogs (52.8%) showed cardiorespiratory signs, 14 (38.9%) had non-specific abnormalities, 2 (5.6%) presented coagulation disorders and 1 (2.8%) had a severe neurological condition. Importantly, four dogs presenting with clinical signs had neither cough nor dyspnea. These results underline that angiostrongylosis should be included in the differential diagnosis, even when dogs display only non-specific clinical signs. The proportion of apparently healthy dogs highlights the relevance of routine copromicroscopic and/or antigenic tests in enzootic areas to avoid the sudden onset of potentially life-threatening signs. [ABSTRACT FROM AUTHOR]

We considered the HIV population of our area, comparing demographic characteristics between 2 consecutive 6-year periods to assess the current patterns of HIV transmission. All HIV-positive patients referred to our hospital from January 1985 to December 1996 were included in the study and were classified into 2 periods: A (January 1985 to December 1990) and B (anuary 1991 to December 1996). The variables analysed were: sex, age at first visit, HIV risk category. A total of 4284 HIV subjects were observed, 2306 in period A vs 1978 in period B (P=ns). Males were 76.3% vs 75.2% (P=ns). Mean age for males was 27.4 vs 32.4 years (P < 0.001) and for females 25.4 vs 30.1 years (P < 0.001). Intravenous drug users (IVDUs) were 88.4% vs 65.4% (P < 0.001), 'heterosexuals' 14.3% vs 24.8% (P < 0.001), 'men who have sex with men' 2.4% vs 4.8% (P < 0.001). Mean age by the main risk groups was: IVDUs 25.9 vs 29.7 years (P < 0.001); heterosexuals 30.4 vs 36 years (P=0.007); 'men who have sex with men' 35 vs 35 years. In conclusion, our study confirms the emerging role of heterosexuals in the current HIV epidemic. People older than teenagers seem to have misperceived their own risk of HIV infection, given the increase in the mean age occurred in the most recent years. This trend suggests the need for prevention strategies focusing more on heterosexual transmission and older people. [ABSTRACT FROM AUTHOR]

Quantitative estimates of vector populations and their infectivity in the wild and in cultivated compartments of agroecosystems have been carried out to elucidate the role of the wild compartment in the epidemiology of Flavescence dorée (FD). Seven sites were selected for the investigations in the Piedmont Region of Italy. They were characterized by a high variety of agricultural and ecological landscape features, and included a vineyard surrounded by wild vegetation. In order to describe abundance and prevalence of FD-infected vectors in the cultivated and wild compartments of the vineyard agroecosystem, adults of Scaphoideus titanus were collected by yellow sticky traps inside and outside the vineyard over the period July 10th–September 9th, 2015. They were counted and singly analyzed for the presence of FD phytoplasmas by PCR. Multifactorial correlations among vector population level, prevalence of infected insects inside and outside the vineyards, disease prevalence in cultivated and wild Vitis plants, and location of wild Vitis plants with respect to the vineyard were analyzed. Abundance of S. titanus adults significantly decreased from the end of July onwards, particularly inside the vineyard (average range 22.7 ± 2.5 insects/trap). Percentage of FD-positive S. titanus was significantly higher outside the vineyard (up to 48% on average) compared to inside the vineyard (up to 34% on average), and increased during the season in both compartments. [ABSTRACT FROM AUTHOR]

Background: Screening of the oral cavity and dental care was suggested as mandatory preventive measures of osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates (BPs). We investigated the occurrence of ONJ before and after implementation of dental preventive measures when starting BP therapy. Patients and methods: Since April 2005, 154 consecutive patients treated with BPs (POST-Group) have undergone a baseline mouth assessment (dental visit ± orthopantomography of the jaws) to detect potential dental conditions and dental care if required. A retrospective review was also conducted of all consecutive cancer patients with bone metastases (PRE-Group) and treated for the first time with BPs from January 1999 to April 2005 in our clinic without receiving any preventive measure. Incidence proportion and incidence rate (IR) were used to estimate the incidence of ONJ. Results: Among the study population (966 patients; male/female = 179/787), 73% had breast cancer. 25% of patients were given zoledronic acid (ZOL), 62% pamidronate (PAM), 8% PAM followed by ZOL and 5% clodronate. ONJ was observed in 28 patients (2.9%); we observed a reduction in the incidence of ONJ from 3.2% to 1.3%, when comparing—pre and post-implementation of preventive measures programme. Considering the patients exposed to ZOL, the performance of a dental examination and the application of preventive measures led to a sustained reduction in ONJ IR (7.8% in the PRE-Group versus 1.7% in the POST-Group; P = 0.016), with an IR ratio of 0.30 (95% confidence interval 0.03–1.26). Conclusions: ONJ is a manageable and preventable condition. Our data confirm that the application of preventive measures can significantly reduce the incidence of ONJ in cancer patients receiving BPs therapy. Dental exams combined to the identification of patients at risk in cooperation with the Dental Team can improve outcomes and increase the number of ONJ-free patients. [ABSTRACT FROM AUTHOR]

Measurement campaigns for airborne particles along a pedestrian route in the city center of Milan were performed by means of a portable instrument consisting of an optical particle counter and a global positioning system (GPS) signal receiver. Based on the size-resolved particle number concentration data and on proper density factors experimentally determined for Milan urban area, the mass concentrations were calculated in terms of particulate matter with aerodynamic diameters ≤10 µm (PM10), ≤2.5 µm (PM2.5), and ≤1 µm (PM1). Besides directly measuring the personal exposure to PM throughout the route, the measurement campaigns pointed out small spatial and temporal variations of the concentration ranges in the different urban microenvironments visited along the route as well as very peculiar features of the particles levels in the underground subway. These findings suggested that the personal exposure of pedestrians in the city center could be estimated by simply taking into account the exposure at the open air and in the subway. The comparison between measured and calculated exposures according to the microenvironment-based estimation results in reasonable accordance, even though the estimations tend to slightly underestimate (12%) the actual measured exposure. [ABSTRACT FROM AUTHOR]

Since the coronavirus disease 2019 (COVID-19) outbreak started, children have been considered marginally involved compared to adults, with a quite significant percentage of asymptomatic carriers. Very recently, an overwhelming inflammatory activation, which shares clinical similarities with Kawasaki disease (KD), has been described in children exposed to COVID-19. We report three KD-like cases that occurred during the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a highly affected area of Northern Italy. The clinical presentation was characterized by the presence of unremitting fever, diarrhea and elevated inflammatory markers. Case #1 and Case #2 occurred one week apart and shared other clinical features: laboratory tests confirmed COVID-19 exposure and high inflammatory activation with myocardial involvement. Case #3 followed a more typical pattern for KD. Interestingly, this patient showed lower levels of procalcitonin, C-reactive protein, D-dimers, and ferritin compared to the other two cases, whereas platelet count was higher. We hypothesize that SARS-CoV-2 might act in children as a trigger, either inducing a classical KD phenotype or causing a systemic inflammatory response leading to a severe KD-like phenotype, eventually characterized by myocardial impairment. We think that bringing these cases and their differences to the attention of the rheumatology community during the COVID-19 pandemic will be beneficial in order to highlight the importance of early diagnosis and to increase awareness of this new phenomenon.