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Registered nurses in the operating room require specialized competencies that surpass basic educational training. Existing national and international documents attempt to outline these competencies but often lack comprehensive details. To address this, a repertoire of technical and professional competencies for operating room nurses, aligned with European and National Qualifications Frameworks, is proposed. Aim: Develop a repertoire of technical and professional competencies for perioperative and perianesthesiological specialist nursing roles. Methods: An at-home ethnography design was employed, utilizing participant observation, interviews to the double, and focus groups. Convenience sampling included 46 participants from a university and a public hospital in northern Italy. Data were collected from September 2021 to June 2023 and analyzed using inductive content analysis and data triangulation. Results: Identified 17 specialized technical professional competencies for perioperative and perianesthesiological nursing, divided into 6 areas of activity. These competencies encompass 19 learning outcomes, 152 tasks, 222 knowledge elements, and 218 skills. Conclusions: This competency repertoire aids in the public recognition of qualifications and serves as a valuable tool for identifying, validating, and certifying competencies. Future research should focus on exploring the competencies of central sterilization nurses and transversal competencies.

Workplaces cause employees to adopt sedentary behaviors for most of their daytime, negatively impacting psychophysical health. A new office concept (UP150) was designed to reduce sedentary behaviors at work through architectural changes, proactive technologies, and wellness coaches (education to active lifestyles). The present study examined the effects of the UP150 concept, previously investigated in dedicated workspaces, with a 12-month longitudinal trial in a real worksite environment. Forty-eight desk workers comprised the experimental (EG) and control (CG) groups. All participants worked in the same working environment, having the UP150 features inserted in a usual working environment, but the CG was not allowed to interact with the UP150 specifics. During the experimental year, physical (physical activity, motor efficiency, and anthropometric features), clinical (metabolic parameters and cognitive-capacity-related parameters), and psychological (well-being and discomfort, job social and psychological perceptions, and perceived workload) features were assessed. The prolonged application of the UP150 procedure in a mixed working context for involvement in corporate policies positively affected EG workers’ physical (physical activity and motor efficiency increased, and body fat unchanged), clinical (blood glucose, insulin, and total cholesterol decreased; HDL increased), and psychological (well-being and social support raised; job demand and perceived workload lowered) parameters, confirming the previous studies.

IntroductionAfter COVID-19 restrictions, hybrid solutions were established that combined smart working and work in presence. Workplace conditions significantly impact employees' lives, particularly in terms of meeting their needs and promoting their wellbeing. Based on a socio-ecological and multilevel methodology, the UP150 concept (Proactive Office 150) represents a possible innovative solution to meet employees' needs and valorize flexible work. It encourages physical exercise and active breaks during the typical workday by using particular architectural modifications, a dedicated App, and physical activity professionals as wellness coaches. The present study is the last step of the preliminary actions planned to check the benefits of the UP150 concept and aims to explore the workers' perceptions after experiencing this project.MethodsThe qualitative analysis of a preliminary survey (concerning information about the company structure and workers' habits) performed before conducting a randomized controlled trial intervention study and the analysis of the semi-structured interviews after 8 weeks of a UP150 experience served as datasets for this study and have been examined and discussed.ResultsIn the preliminary survey, the young (under 40) and generally active (57% of the workers) reported being motivated to exercise but inhibited by a lack of time and a heavy workload. After 8 weeks at a modified workplace designed in accordance with the motive behind the UP150, the workers displayed noticeable positive perceptions and appreciation.DiscussionThe qualitative analysis confirmed and supported the effectiveness of the UP150 concept that previous research had already found in quantitative parameters related to employees' motor efficiency, psychophysical status, and amount of physical activity. Participants reported beneficial perceived effects on their wellness and psychophysical status following a UP150 experience. Moreover, the concept improved social relationships and increased motivation. In conclusion, the UP150 concept efficiently fostered a positive perception of physical exercise and directed the employees toward the assumption of healthy behaviors fitting the physical literacy paradigm.

Intersectoral actions in the sport-for-development field constitute a pre-condition for the implementation of sport-based interventions. At an operational level, the multi-professional group is the tool through which intersectoral collaboration may successfully achieve its aims. Despite the prominent role of the group, this topic is under-researched in terms of understanding intersectoral actions in the sport-for-development field. By applying a psycho-sociological perspective, our research explores the role of the multi-professional group as a limit/resource for sport-for-development workers that operate with vulnerable youth. Following a phenomenological interpretive approach, 12 practitioners (six sport workers and six social workers) participated in semi-structured interviews to explore the role of multi-professional groups as a resource/limit in working with socially vulnerable youth through sport. The results indicate that, in the participants’ experience, belonging to a multi-professional group is a meaningful resource to trigger reflexivity, promote collaboration and integrate their different professions. The interviews highlighted the positive potential of this tool to address the challenges that emerge when working with socially vulnerable youth, including the management of negative emotions, unexpected events and the relationship with young people. Some interviews also suggested that the presence of multiple professions, under certain circumstances, may be a risk when working with youth. These findings have significant value for programme design, strategy and management as they show the value of trans-disciplinary practices as an agenda for social inclusion through sport.

Self-regulation of learning (SRL) is a key psychological factor that supports young athletes aiming to reach the elite level by promoting their involvement in deliberate practice. We contributed to the validation of the Italian version of the Bartulovic et al. (2017) Self-Regulation of Learning – Self-Report Scale for Sport Practice by testing its factorial structure, reliability, and measurement invariance among elite and non-elite football players, involving 415 male professional, semi-professional, and amateur youth academy players (Mage = 16.2, SD = 1.51). The original six-factor structure (planning, reflection, effort, self-efficacy, self-monitoring, and evaluation) did not fit the data well and a five-factor solution (where self-monitoring and evaluation items load on the same factor, named “self-supervision”) was a better fit. This five-factor solution was measurement invariant across groups of elite and non-elite athletes. We found that elite athletes scored significantly higher than non-elite ones in each SRL subprocess. Implications for future validation studies and for the use of this tool are discussed.

Because of the gradual aging of the population, hospital facilities for socio-sanitary care of the elderly are quite scarce relative to the very high number of elderly people present in the country. This has pushed a high number of families to privately hire home-care workers. The scientific literature gives a picture of the psycho-physical risks that this type of profession is exposed to; however, there is still a need for a more systemic reflection with regard to representations about their role and competences. The aim of the present study is to outline the representations of the role and the skills it requires from home-care workers’ point of view. We reconstructed how home-care workers perceive and define the profession, and understand the necessary skills required from their point of view. Our results show that the professional profile of home-care workers still remains poorly defined and that professionals themselves struggle to find value and recognition, and to articulate what the skill set they develop is formed of.

Well-being in youth sport is a growing topic in literature. Practicing sports at a youth level is recognized as an important opportunity for growth and development but also an experience that conversely can prove to be tiring and cause discomfort. Sometimes expectations and pressures make it a risky experience. This is emphasized even more when looking at very popular and spectacular sports, such as football in some European Countries; practicing football often solicits the hope of becoming champions one day and thus being able living thanks to the beloved sport. How do young Italian football practitioners feel? What role do relationships with significant others belonging to the world of sport and extra-sport play on the well-being of young athletes? On which specific aspects of psychological well-being (PWB) are these relationships based? Are there any differences between elite and amateurs levels? These are the questions upon which this paper focuses, considering a sample of young Italian football practitioners. Analysis reveals a strong and positive influence of some dimensions of the relationships with significant others on PWB, specifically team effort, coach closeness, and parental learning climate. Moreover, elite players perceive significantly better relationships than sub-elite and amateurs and have significantly higher levels of PWB. Those results provide a first evidence for the importance of good relationships within and outside sport for an effective development of youth football players since they positively influence players’ PWB, which is higher in elite players. It emerges the necessity to further investigate different aspects of PWB and to deepen the knowledge about the meaning of relationship in developmental athletes according to a psychosocial approach.

Introduction: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease affecting the synovial joints and causing severe disability. Environmental and lifestyle factors, including diet, have been proposed to play a role in the onset and severity of RA. Dietary manipulation may help to manage the symptoms of RA by lowering inflammation and potentially decreasing pain. Methods: In 40 patients with long-standing RA with stable symptoms and treated with conventional (c-) and biological (b-) disease modifying anti-rheumatic drugs (DMARDs), the effect of a 3-month diet avoiding meat, gluten, and lactose (and all dairy products; privative diet) was evaluated in comparison with a control balanced diet including those foods. Both diets were designed to reduce weight since all patients were overweight or obese. Patients were randomly assigned to one of the diets, and RA was clinically assessed at Time 0 (T0), through the Visual Analogue Scale (VAS), for pain, and the Disease Activity Score of 28 joints (DAS 28) for RA activity. Patients were also administered the Short Form Health survey (SF-36) and the Health Assessment Questionnaire (HAQ). At T0, a blood sample was collected for laboratory tests and adipokines measurements, and anthropometric measurements were compared. These evaluations were repeated at the end of the 3 months’ dietary regimens. Results: A significant decrease in VAS and the improvement of the overall state of physical and mental health, assessed through SF-36, was observed in patients assigned to the privative diet. Both dietary regimens resulted in the improvement of quality of life compared to baseline values; however, the change was significant only for the privative diet. With either diet, patients showed significant decreases in body weight and body mass index, with a reduction in waist and hips circumference and lower basal glucose and circulating leptin levels. A privative diet was also able to significantly reduce systolic (p = 0.003) and diastolic (p = 0.025) arterial pressure. The number of circulating leukocytes and neutrophils, and the level of hs-C-Reactive Protein also decreased after 3 months of the meat-, lactose-, and gluten-free diet. Conclusions: Our results suggest that a privative diet can result in a better control of inflammation in RA patients under stable optimized drug treatment.

Antiphospholipid syndrome (APS) is characterized by arterial and venous thrombosis, pregnancy morbidity and fetal loss caused by pathogenic autoantibodies directed against phospholipids (PL) and PL-cofactors. Isolated neurological APS may represent a significant diagnostic challenge, as epidemiological, clinical and neuroimaging features may overlap with those of multiple sclerosis (MS). In an open view, MS could be considered as an organ-specific anti-lipid (phospholipid and glycosphingolipid associated proteins) disease, in which autoreactive B cells and CD8+ T cells play a dominant role in its pathophysiology. In MS, diverse autoantibodies against the lipid-protein cofactors of the myelin sheath have been described, whose pathophysiologic role has not been fully elucidated. We carried out a review to select clinical studies addressing the prevalence of antiphospholipid (aPL) autoantibodies in the so-called MS-like syndrome. The reported prevalence ranged between 2% and 88%, particularly aCL and aβ2GPI, with predominant IgM isotype and suggesting worse MS prognosis. Secondarily, an updated summary of current knowledge on the pathophysiological mechanisms and events responsible for these conditions is presented. We draw attention to the clinical relevance of diagnosing isolated neurological APS. Prompt and accurate diagnosis and antiaggregant and anticoagulant treatment of APS could be vital to prevent or at least reduce APS-related morbidity and mortality.

Social inclusion is broadly recognized as a priority to accomplish at an international level. While the influence of sport toward this social mission has been largely debated, literature lacks contributions capturing the challenges of sport when promoting social inclusion. Based in case study methodology, the investigation explores the impact of a multi-stakeholder sport initiative developing social inclusion for socially vulnerable youth and the related challenges of the intervention through in-depth interviews with diverse program stakeholders. The main findings indicated the emergence of four challenges: limited transferability of program outcomes for youth in living conditions of severe vulnerability; drop-out of youth in living conditions of severe vulnerability; limited sustainability of program social workers; lack of sports club management skills. The work highlights some limits of sport-based programs for social inclusion and discusses some implications for practice to maximize the societal impact of such interventions.

A fronte di uno scenario di profonda crisi delle carceri italiane e dell’urgenza di rivedere il senso e il significato di tale istituzione sono in aumento le iniziative di promozione di pratiche di custodia e trattamentali innovative. Lo studio fa riferimento a una delle carceri italiane più all’avanguardia nella gestione trattamentale e rieducativa dei detenuti (celle aperte, auto-organizzazione dei detenuti di attività ricreativo-culturali, promozione di attività lavorative cooperative sia all’interno che all’esterno del carcere), con lo scopo di studiare se e come questo cambio di cultura detentiva abbia generato trasformazioni organizzative che impattano anche sul benessere professionale degli operatori che presidiano la gestione dei detenuti negli istituti di pena. Attraverso uno studio qualitativo che ha visto il coinvolgimento di 15 agenti di polizia penitenziaria dei 3 reparti maggiormente critici dell’istituto in quanto ospitano i cosiddetti detenuti ‘protetti’ (condanne alte, tossicodipendenti e sex offenders), vengono indagati i vissuti e le rappresentazione dei soggetti circa il proprio ruolo e alcuni aspetti della vita organizzativa indicatori del loro benessere professionale.

The growing incidence of cardiovascular disease (CVD) has promoted investigations of natural molecules that could prevent and treat CVD. Among these, hydroxytyrosol, a polyphenolic compound of olive oil, is well known for its antioxidant, anti-inflammatory, and anti-atherogenic effects. Its strong antioxidant properties are due to the scavenging of radicals and the stimulation of synthesis and activity of antioxidant enzymes (SOD, CAT, HO-1, NOS, COX-2, GSH), which also limit the lipid peroxidation of low-density lipoprotein (LDL) cholesterol, a hallmark of atherosclerosis. Lowered inflammation and oxidative stress and an improved lipid profile were also demonstrated in healthy subjects as well as in metabolic syndrome patients after hydroxytyrosol (HT) supplementation. These results might open a new therapeutic scenario through personalized supplementation of HT in CVDs. This review is the first attempt to collect together scientific literature on HT in both in vitro and in vivo models, as well as in human clinical studies, describing its potential biological effects for cardiovascular health.

The role of inflammation and dysfunction of the cholinergic system in obstructive sleep apnea (OSA) has not exhaustively clarified. Thus, in this study, we explore the non-neuronal cholinergic system and the balance of T helper (Th) 17- and T regulatory (Treg)-related cytokines in OSA patients. The study includes 33 subjects with obstructive sleep apnea and 10 healthy controls (HC). The expression levels of cholinergic system component, RAR-related orphan receptor (RORc), transcription factor forkhead box protein 3 (Foxp3) and cytokines were evaluated. Th17- and Treg-related cytokines, choline levels and acetylcholinesterase (AChE), butyrylcholinesterase (BuChE) activity were quantified in OSA and control subjects. AChE and nicotinic receptor α 7 subunit (α7nAChR) gene expression and serum levels of choline, AChE and BuChE were lower in OSA patients than in the HC group. Compared with the HC group, OSA patients exhibited an increased expression, secretion and serum levels of pro-inflammatory cytokines, a reduced expression, secretion and serum levels of transforming growth factor (TGF)β and reduced Foxp3 mRNA levels. The Th17/Treg-related cytokine ratio was higher in the OSA group. Our results confirm and reinforce the hypothesis that OSA may be considered a systemic inflammatory disease, and that an imbalance of non-neuronal cholinergic and pro/anti-inflammatory cytokines may contribute to development and progression of comorbidities in OSA subjects. The evaluation of Th17/Treg-related cytokine may provide an additional explanation for OSA pathogenesis and clinical features, opening new directions for the OSA management.

To test whether gas and oil field work is accompanied by stress and altered immune function, the perception of workplace stress, levels of salivary cortisol, plasma levels, and mononuclear cell production of cytokines were examined in 80 healthy workers recruited among a population of operators on gas and oilfields. Specific questionnaires for determining the perception of anxiety, occupational stress, and subjective symptoms were administered. Salivary cortisol and cytokines plasma levels were evaluated by Elisa and to investigate immune function, both spontaneous and PHA- or LPS-induced expression and production of cytokines were assessed by qRT-PCR. Workers showed medium stress levels at work, with growth and increased motivation for work, and based on salivary cortisol concentrations, were divided into two groups of ≤10 ng/mL (n = 31) or >10 ng/mL (n = 49). Statistically significant higher plasma levels of IL-6, while lower TNFα, were detected in workers with cortisol >10 ng/mL. Also, BMI, DL, JD and Job strain were significantly higher in workers with cortisol >10 ng/mL. Thus, even modest variations of cortisol might have a role in the modulation of immune response and worker’s vulnerability to health imbalance.Thus, the evaluation of immune status, in addition to cortisol levels, could be useful to prevent illnesses; exacerbation of pre-existing conditions; morbidity; and consequent absences from work, with economic repercussions.

BackgroundMultiple sclerosis (MS) is a chronic, progressive autoimmune disease of the central nervous system in which inflammation plays a key role in the induction, development, and progression. Most of the MS patients present with relapsing–remitting (RR) form, characterized by flare-ups followed by periods of recovery. Many inflammatory and anti-inflammatory cytokines have been proposed as backers in MS pathogenesis, and the balance between these differing cytokines can regulate MS severity. Interferon (IFN)-β, a current disease-modifying therapy for MS, has demonstrated beneficial effects in reducing disease severity in MS patients. However, its immunoregulatory and anti-inflammatory actions in MS are not wholly understood. The aim of the study was to define, in clinically stable patients with RR-MS, the serum concentration of several cytokines, canonical or not, and their modulation by IFN-β therapy.MethodsRelapsing–remitting-MS patients were enrolled and diagnosed according to revised Mc Donald Diagnostic Criteria. A set of cytokines [including non-canonical neurotransmitter acetylcholine (ACh) and adipokines] and B-cell differentiation molecules, as potential biomarkers, were evaluated in 30 non-treated RR-MS patients compared to 30 IFN-β-treated MS patients and 30 age, gender, and body mass index-matched healthy controls (HC).ResultsNaïve MS patients showed significantly higher levels of interleukin (IL)-1β, IL-12/IL-23p40, IL-18, high-mobility group box protein-1, and IL-18 binding protein (IL-18BP) than MS-treated patients (p

Over the years – due to the aging population, the process of corporatisation and a demand for a higher quality of services – professionals who work in Care Homes have been exposed to an increasing risk of physical and emotional malaise because of the number of challenges they’ve been asked to manage. Given these factors, there is a growing interest in the study and understanding of professions in geriatric care settings. In the literature there is a prevalence of quantitative studies offering an overview in terms of indicators – at the individual or group or organizational level – concerning the potential development of situations of professional malaise. Conversely, there is a lack of qualitative studies exploring the risk and protection factors. For this reason, in this study we decided to use a qualitative approach to explore “more up close” this kind of organizational context and to keep together the different levels in systemic terms in order to identify – according to professionals’ perceptions – resource factors (in order to leverage these aspects) and fatigue factors (to identify them and treat them). Three Italian Care Homes were involved and the interview’s sample was composed of 45 professionals – 15 nurses, 30 total Patient Care Assistants (PCAs) and Auxiliary Care Assistants (ACAs), of these, 17 males and 28 females, with an average age of 43 years (SD = 0.78) – selected using a sampling of maximum variability. From the analysis of the materials there seem to be four profiles of the professionals involved. Implications to ensure a functional human resource management are discussed for the purpose of promote the well-being of the various professionals, and, as a result, an increasing quality of service.

Aging is characterized by the progressive decline of physiological function and tissue homeostasis leading to increased vulnerability, degeneration, and death. Aging-related changes of the innate and adaptive immune system include decline in the preservation and enhancement of many immune functions, such as changes in the number of circulating monocytic and dendritic cells, thymic involution, T cell polyfunctionality, or production of proinflammatory cytokines, and are defined as immunosenescence. Inflammatory functions are increased with age, causing the chronic low-grade inflammation, referred to as inflamm-aging, that contribute, together with immunosenescence, to neurodegenerative diseases. In this review, we discuss the link between the immune and nervous systems and how the immunosenescence and inflamm-aging can contribute to neurodegenerative diseases.

Inflammation persists in patients infected with HIV. Reduction of inflammatory cytokines and microbial translocation might be one way that this could be managed. Purpose: The anti-inflammatory properties of certain probiotic strains prompted us to investigate whether a probiotic could reduce the inflammatory index of HIV-infected patients. Methods: The study involved 30 HIV+ males on antiretroviral therapy, who were given one bottle of fermented milk Yakult Light® containing Lactobacillus casei Shirota (LcS) twice a day for four weeks. Results: The probiotic LcS was associated with an increase of T lymphocytes and a significant increase of CD56+ cells (p = 0.04). There was also a significant decrease of mRNA levels of TGFβ, IL-10 and IL-12 (p < 0.001) and IL-1β expression (p < 0.001) and an increase of serum IL-23 (p = 0.03). In addition, decreased inflammation and cardiovascular risk were observed, as shown by a reduction of cystatin C (p < 0.001). Conclusions: These data provide preliminary evidence that probiotic supplementation may modulate certain immunological parameters and some of the cytokines that were analyzed. Thus, we propose that LcS may be an inexpensive and practical strategy to support the immune function of HIV+ patients.

Several clinical studies have suggested the impact of sinusoidal and pulsed electromagnetic fields in quickening wound repair processes and tissue regeneration. The clinical use of extremely low-frequency electromagnetic fields could represent a novel frontier in tissue repair and oral health, with an interesting clinical perspective. The present study aimed to evaluate the effect of an extremely low-frequency sinusoidal electromagnetic field (SEMF) and an extremely low-frequency pulsed electromagnetic field (PEMF) with flux densities of 1 mT on a model of oral healing process using gingival fibroblasts. An in vitro mechanical injury was produced to evaluate wound healing, migration, viability, metabolism, and the expression of selected cytokines and protease genes in fibroblasts exposed to or not exposed to the SEMF and the PEMF. Interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-β), metalloproteinase 2 (MMP-2), monocyte chemoattractant protein 1 (MCP-1), inducible nitric oxide synthase (iNOS), and heme oxygenase 1 (HO-1) are involved in wound healing and tissue regeneration, favoring fibroblast proliferation, chemotaxis, and activation. Our results show that the exposure to each type of electromagnetic field increases the early expression of IL-6, TGF-β, and iNOS, driving a shift from an inflammatory to a proliferative phase of wound repair. Additionally, a later induction of MMP-2, MCP-1, and HO-1 was observed after electromagnetic field exposure, which quickened the wound-healing process. Moreover, electromagnetic field exposure influenced the proliferation, migration, and metabolism of human gingival fibroblasts compared to sham-exposed cells. This study suggests that exposure to SEMF and PEMF could be an interesting new non-invasive treatment option for wound healing. However, additional studies are needed to elucidate the best exposure conditions to provide the desired in vivo treatment efficacy.

Riassunto Da sempre il cambiamento costituisce un processo delicato e complesso per le persone, i gruppi e le organizzazioni che lo vivono. Il presente lavoro, a partire da un processo di riorganizzazione che ha coinvolto un istituto penitenziario lombardo, prende in analisi le resistenze al cambiamento generatesi in un gruppo di quindici ispettori e la loro evoluzione lungo un percorso formativo che li ha visti coinvolti.Il contributo si pone lo scopo di compiere un’indagine esplorativa sul ruolo del dispositivogruppale attivato dalla formazione, come strumento in grado di accompagnare e far evolvere le resistenze al cambiamento. Al fine di comprendere se, e in che modo, la micro-organizzazione temporanea creata durante la formazione è stata in grado di accompagnare i soggetti a trattare le difese emergenti dal processo di cambiamento, è stata compiuta un’analisi del contenuto carta-matita delle trascrizioni di sette sessioni formative. L’analisi ha consentito di mettere in luce alcune tipologie di resistenze del gruppo quali ad esempio lo spostamento dei problemi, la lettura individuale degli stessi, la prevalenza della lamentela e l’attesa messianica di una figura apicale che decida come intervenire. L’evolversi del percorso formativo, attraverso specifiche attività proposte e azioni messe in atto dal formatore, ha consentito al gruppo di fare un progressivo passaggio verso uno sblocco del pensiero progettuale ed un atteggiamento più attivo e propositivo. Le resistenze sono state accolte e accompagnate, dando modo alle emozioni (di frustrazione, rabbia, stanchezza, ecc) di trovare parola, ed essere liberate per poi lasciar posto ad un nuovo pensiero progettuale di gruppo.Parole chiave:cambiamento organizzativo, resistenze al cambiamento, gruppo di formazioneTraining and resistance to change. A group of prison inspectorsAbstract Change has always been a delicate and complex process for individuals, groups and organizations who live it. The present work deals with a process of reorganization which involved a prison in Lombardy. It analyzes the resistance to change generated in a group of fifteen inspectors and their evolution along a training program that has seen them involved. The contribution is intended to carry out an exploratory survey on the role of group device activated by training, as a device able to accompany and let resistance evolve to change. In order to understand if and how the micro-temporary organization created during the training was able to accompany the subject to treat the defences emerging from the process of change, a content analysis of the transcripts of seven training sessions was performed. The analysis made it possible to highlight certain types of resistances of the group such as the displacement of problems, the individual reading of the same, the prevalence of the complaint and the expectation of a messianic apical figure who decides how to intervene. The development of the course, through specific proposed activities and actions taken by the trainer, has allowed the group to make a gradual transition to a more active and purposeful position. The resistors were accepted and nurtured, giving way to the emotions (frustration, anger, fatigue, etc.) to find the word, and then be released to make way for a new group-thinking about the change. Key word: organizational change, resistance to change, training groups.

Neurodegenerative diseases comprise both hereditary and sporadic conditions characterized by an identifying progressive nervous system dysfunction and distinctive neuopathophysiology. The majority are of non-familial etiology and hence environmental factors and lifestyle play key roles in their pathogenesis. The extensive use of and ever increasing worldwide demand for electricity has stimulated societal and scientific interest on the environmental exposure to low frequency electromagnetic fields (EMFs) on human health. Epidemiological studies suggest a positive association between 50/60-Hz power transmission fields and leukemia or lymphoma development. Consequent to the association between EMFs and induction of oxidative stress, concerns relating to development of neurodegenerative diseases, such as Alzheimer disease (AD), have been voiced as the brain consumes the greatest fraction of oxygen and is particularly vulnerable to oxidative stress. Exposure to extremely low frequency (ELF)-EMFs are reported to alter animal behavior and modulate biological variables, including gene expression, regulation of cell survival, promotion of cellular differentiation, and changes in cerebral blood flow in aged AD transgenic mice. Alterations in inflammatory responses have also been reported, but how these actions impact human health remains unknown. We hence evaluated the effects of an electromagnetic wave (magnetic field intensity 1 mT; frequency, 50-Hz) on a well-characterized immortalized neuronal cell model, human SH-SY5Y cells. ELF-EMF exposure elevated the expession of NOS and O2(-), which were countered by compensatory changes in antioxidant catylase (CAT) activity and enzymatic kinetic parameters related to CYP-450 and CAT activity. Actions of ELF-EMFs on cytokine gene expression were additionally evaluated and found rapidly modified. Confronted with co-exposure to H2O2-induced oxidative stress, ELF-EMF proved not as well counteracted and resulted in a decline in CAT activity and a rise in O2(-) levels. Together these studies support the further evaluation of ELF-EMF exposure in cellular and in vivo preclinical models to define mechanisms potentially impacted in humans.

Multiple sclerosis (MS) is characterized by pro-inflammatory cytokine production. Acetylcholine (ACh) contributes to the modulation of central and peripheral inflammation. We studied the homeostasis of the cholinergic system in relation to cytokine levels in immune cells and sera of relapsing remitting-MS (RR-MS) patients. We demonstrated that lower ACh levels in serum of RR-MS patients were inversely correlated with the increased activity of the hydrolyzing enzymes acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). Interestingly, the expression of the ACh biosynthetic enzyme and the protein carriers involved in non-vesicular ACh release were found overexpressed in peripheral blood mononuclear cells of MS patients. The inflammatory state of the MS patients was confirmed by increased levels of TNFα, IL-12/IL-23p40, IL-18. The lower circulating ACh levels in sera of MS patients are dependent on the higher activity of cholinergic hydrolyzing enzymes. The smaller ratio of ACh to TNFα, IL-12/IL-23p40 and IL-18 in MS patients, with respect to healthy donors (HD), is indicative of an inflammatory environment probably related to the alteration of cholinergic system homeostasis.

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been suggested for the potential treatment of neurodegenerative diseases, such as Alzheimer’s disease (AD). Prolonged use of NSAIDs, however, produces gastrointestinal (GI) toxicity. To overcome this serious limitation, the aim of this study was to develop novel NSAID-derived drug conjugates (Anti-inflammatory-Lipoyl derivatives, AL4–9) that preserve the beneficial effects of NSAIDS without causing GI problems. As such, we conjugated selected well-known NSAIDs, such as (S)-naproxen and (R)-flurbiprofen, with (R)-α-lipoic acid (LA) through alkylene diamine linkers. The selection of the antioxidant LA was based on the proposed role of oxidative stress in the development and/or progression of AD. Our exploratory studies revealed that AL7 containing the diaminoethylene linker between (R)-flurbiprofen and LA had the most favorable chemical and in vitro enzymatic stability profiles among the synthesized compounds. Upon pretreatment, this compound exhibited excellent antioxidant activity in phorbol 12-miristate 13-acetate (PMA)-stimulated U937 cells (lymphoblast lung from human) and Aβ(25–35)-treated THP-1 cells (leukemic monocytes). Furthermore, AL7 also modulated the expression of COX-2, IL-1β and TNF-α in these cell lines, suggesting anti-inflammatory activity. Taken together, AL7 has emerged as a potential lead worthy of further characterization and testing in suitable in vivo models of AD.