Implementation of a quality management system according to ISO 9001:2015 standards in an Angiology Unit: an Italian experience.

Background: The International Standardization Organization operates the world's most widely recognized quality management system standard, the ISO 9001:2015. In the healthcare sector, the adoption of this standard within an organization helps to improve the overall performance and provides a foundation for development and continuous progress. Our study aims to describe the implementation process of a quality management system according to the ISO 9001:2015 standards in an Angiology Unit of an Italian Univer-sity hospital. Methods: The project was structured in 5 operational phases, which were carried out during a time frame of 14 months (March 2018-May 2019) and entailed several improvement actions associated with quality and safety outputs such as clinical management, clinical practice, safety, and patient-centeredness. Results: Implementation of the quality management system led to the improvement of many aspects of the processes performed in the Angiology Unit, both in the outpatient and day hospital setting. Overall, the project positively impacted on systems for patient safety, particularly in communication and data transmis-sion, and clinical leadership. Conclusions: The implementation of the ISO 9001 certification is a process that apparently may seem ex-pensive in terms of resources used, commitment, work, comparison, but it leads to substantial and always progressive improvements in the offer of Services to the user, safety both for the users and for the healthcare personnel involved, in addition to the care processes that translate into significant benefits in terms of quality of care for patients, as well as management savings for the organization.

Source apportionment of particulate matter in a large city of southeastern Po Valley (Bologna, Italy).

This study reports the results of an experimental research project carried out in Bologna, a midsize town in central Po valley, with the aim at characterizing local aerosol chemistry and tracking the main source emissions of airborne particulate matter. Chemical speciation based upon ions, trace elements, and carbonaceous matter is discussed on the basis of seasonal variation and enrichment factors. For the first time, source apportionment was achieved at this location using two widely used receptor models (principal component analysis/multi-linear regression analysis (PCA/MLRA) and positive matrix factorization (PMF)). Four main aerosol sources were identified by PCA/MLRA and interpreted as: resuspended particulate and a pseudo-marine factor (winter street management), both related to the coarse fraction, plus mixed combustions and secondary aerosol largely associated to traffic and long-lived species typical of the fine fraction. The PMF model resolved six main aerosol sources, interpreted as: mineral dust, road dust, traffic, secondary aerosol, biomass burning and again a pseudo-marine factor. Source apportionment results from both models are in good agreement providing a 30 and a 33% by weight respectively for PCA-MLRA and PMF for the coarse fraction and 70% (PCA-MLRA) and 67% (PMF) for the fine fraction. The episodic influence of Saharan dust transport on PM10 exceedances in Bologna was identified and discussed in term of meteorological framework, composition, and quantitative contribution.

PIXE analysis of some medicinal plants used in cleaning teeth in southwestern Nigeria.

Sixteen medicinal plants used for cleaning teeth in southwestern Nigeria were analyzed using the particle-induced X-ray emission (PIXE) technique. These medicinal plants have other therapeutic uses, but the emphasis and main focus were on their beneficial effects on human teeth. PIXE measurements were carried out using 1.8 MeV collimated proton beam from the 2.5 MV AN 2000 Van de Graaff accelerator at the Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Legnaro, Padova Italy. The results showed the presence of 18 different elements at different concentrations, 2 plants had traces of gold, and none of the plants contained any toxic heavy metals. The metabolic roles of the detected elements were discussed especially as they affected the formation, growth, development, and protection of human teeth. The results of this study are presented and discussed.

Evaluation of Nigerian animal feeds by particle-induced X-ray emission.

There is need to evaluate the locally available animal feeds in Nigeria so as to be able to combine them in acceptable proportions to the animals to achieve the desired growth rate. The technique of particle-induced X-ray emission (PIXE) was employed for the evaluation of these locally available animal feeds, which include Panicum maximum (Guinea grass), Cynodon plectostachyum (grass), Leucaena leucephala (legume), Calopogonium mucunoides (legume), Gliricidia sepium (legume), Euphorbia polychrome (legume), Pueraria phaseloides (legume), and Centrosema pubescens (legume). The proton beam delivered by the 2.5-MV AN 2,000 Van de Graaff accelerator at the International Centre for Theoretical Physics Laboratori Nazionali di Legnaro (LNL), Padova, Italy was used for the PIXE measurements. Twenty-one different elements were detected at various concentrations and their nutritional effects on different animals are discussed.

Study of release of eosinophil cationic proteins (ECP and EPX) in the hypereosinophilic syndrome (HES) and other hypereosinophilic conditions.

BACKGROUND: Up to date, the etiology and the pathogenesis of HES are still unknown and particularly it is unclear why eosinophils in HES are more aggressive towards tissues than in other eosinophilic conditions. METHODS: We assessed the cationic proteins ECP and EPX serum concentrations, their in vitro release from polymorphonuclear cell culture, and the monoclonal antibodies EG1 and EG2 in 3 patients with HES, 6 patients with other hypereosinophilic conditions and 20 healthy control subjects. RESULTS: Serum ECP and EPX concentrations were higher in eosinophilic patients than in healthy subjects. Hypereosinophilic patients had more EG2+ cells than healthy subjects, but EG2+ rate failed to differentiate HES from other hypereosinophilic conditions (p = 0.074). Moreover, the release in vitro of ECP and EPX was significantly higher in HES patients (p < 0.05). CONCLUSIONS: Our preliminary results seem to suggest the importance of functional data, such as ECP and EPX release, in differentiating HES from other hypereosinophilic diseases. Particularly, ECP and EPX release in vitro is higher in cell cultures from HES patients than from patients with other hypereosinophilic conditions.

PIGE-PIXE analysis of medicinal plants and vegetables of pharmacological importance.

PIGE and PIXE techniques were employed to the study of elemental constituents of some traditional medicinal plants generally used in curing many diseases and ailments in southwestern Nigeria. Analyses were also carried out on commonly edible vegetables of medicinal and pharmacological importance. PIGE measurements were carried out using 3.5-MeV collimated protons from the 7 mV CN Van-de-Graaff accelerator of INFN, LNL, Legnaro (Padova), Italy, whereas the PIXE measurements were carried out using 1.8 MeV from the 2.5 MV AN 2000 Van-de-Graaff accelerator of the same laboratory. The results show that many of the medicinal plants contain elements of cardinal importance in human metabolism. The results from the vegetables also show the presence of vital elements that are needed for growth and development. In addition, some of the toxic elements, which include As, Cd, Hg, and so forth, were not detected. However, some of the recipes contain trace amounts of Pb at very low concentrations. This calls for proper control of dose rates in some samples to prevent the attendant negative cumulative effects.