Effect of UV-C Treatment on Shelf Life of Soft Wheat Bread (Bun).

The effect of exposure of soft wheat buns to Ultraviolet-C radiation (UV-C, 253.7 nm) was studied as an alternative to conventional treatments to control fungal spoilage and prolong shelf life. To identify the most suitable operating conditions, the study included preliminary tests on the permeability of films to UV-C irradiation, and on treatment antifungal efficacy on target microorganisms (Penicillium digitatum and Saccharomycopsis fibuligera) in Petri dishes. A 125 µm T9250B film (Cryovac® Sealed Air S.r.l), commercially available for long-life bread treated with ethanol and conditioned in a modified atmosphere, was selected to pack buns before the UV-C treatment. The study was carried out along with the observation of the fungal growth of buns artificially inoculated with suspensions of P. digitatum and S. fibuligera, treated under UV-C at a distance of 25 cm between bread and the 15 W UV-C source, in comparison to untreated buns used as control. Estimation of fungal growth as well as sensory evaluation was made 2, 4, 7, 10 and 14 days after the treatment. UV-C treated buns showed a noticeable reduction of fungal spoilage and kept a tender texture for up to two weeks after packaging. UV-C treatment represents a good opportunity for the bakery industry, reducing costs and ensuring a prolonged shelf life of a commercial product, respecting the health and hedonistic expectations of the customers.

Health coaching for undergraduate nursing students: a pilot study for an action research.

BACKGROUND AND AIM: The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students. METHOD: A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy. RESULT: This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course. CONCLUSION: This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.

Missed care and support figures: Preliminary investigation in some surgical ward.

INTRODUCTION: Missed Nursing care (MNC) is defined as planned care in the patients care process that is omitted or delayed. Despite their importance in Italy, there are just few studies that measure MNC's prevalence and causes. We are not aware of studies published in literature that have related MNC with the presence or absence of support staff. OBJECTIVES: This study's objective, was to measure nurse's perception and reasons for missed care in surgical wards with or without Health Care Assistants (HCA), and, to assess whether there is a significant difference between the two groups of nurses. METHODOLOGY: A Cross-sectional observational study was conducted through the administration of the "Missed Nursing Care Survey" in the Italian Version to nurses of the wards surveyed. RESULTS: Results have confirmed that the most frequent MNC are hygiene and mobilisation activities as reported in other Italian and foreign studies, with higher frequency in wards without HCAs. Also, the study confirmed other Italian and foreign study results recognising the most significant motivation for MNC's as the lack of staff and unexpected events. CONCLUSIONS: Without wishing to attribute a cause/effect relation, it is interesting to assess the results, which seem to show that the presence of HCAs contributes to reduce the prevalence of missed activities. The lack of staff has revealed higher average of MNC for both groups, which seems to direct our attention not only towards the presence of HCAs but in regards to their inclusion in care activities. It may be necessary to reflect on the priority that nurses give to certain activities.

Medication administration and anxiety: an observational study with nursing students.

BACKGROUND AND AIM: Medication administration errors represent a topic of great scientific interest. Medication administration is considered by nursing students a complex process during which it is easy to make mistakes; therefore, institutional measures have been adopted in order to reduce medication errors. However, it remains a critical issue in nursing practice for which several causes have been identified, including environmental factors and individual knowledge. Mistakes can be made by nurses and especially by students who must cope with additional causal factors including anxiety management. The aim was to investigate state anxiety levels among nursing students when it comes to medication administration. RESEARCH DESIGN AND METHODS: An observational study involving a convenience sample of 150 nursing students from a Northern Italy University has been conducted; they were asked to complete a questionnaire to measure the levels of state anxiety in relation to medication administration.   Results. There were no particularly high levels of state anxiety among students associated with medication administration; however, state anxiety levels were slightly higher in third-year students than in second-year students, and this is most likely due to the growing complexity of the medication administration process compared to the lack of experience.   Conclusions. Although the results don't show statistically significant data, the effectiveness of nursing education plays a crucial role in reducing medication errors, which is why it is essential to provide suitable tools for the professionals of the future and invest in clinical simulations.

The safety of care focused on patient identity: an observational study.

BACKGROUND AND AIM: Healthcare organizations, in order to reduce errors and extend the number of safe practices, are looking for possible solutions to enhance the clients' health quality care and trying to spread the culture of safety healthcare. Although in the literature the field of research "patient safety" is very debated, there are few empirical studies that investigate about the strategies undertaken by nursing students for the patients identification process during their care pathway. The aim of this study is to investigate the knowledge of the Ministerial Recommendation No. 3/2008 among nursing students, a specific Italian directive that aims to guarantee the safety of cares. METHODS: A four-weeks single-center observational study was conducted, involving a convenient sample of 112 students of the 2nd and 3rd  year of the Nursing Course Degree of the University of Parma. The survey was conducted using an ad-hoc questionnaire. RESULTS: The use of the identification wristband is considered one of the most important strategy to make sure the patient identification; unfortunately it is in practice used just in few occasions and only when performed specific procedures; it is furthermore noted that patients are not enough informed about the use and finalities of the identification wristband. CONCLUSIONS: Considering the importance of the patient identification process to guarantee the  safety of cares, the results produced, suggest that this investigation field deserves further insights in order to collect more substantial data and expand knowledge on the specific subject, so as to fill  knowledge gaps and sensitize nursing students to the correct use of the identification wristband.

Intraosseus access vs ecoguided peripherical venous access in emergency and urgency: a systematic review.

BACKGROUND AND AIM OF THE WORK: Ensuring vascular access in emergency conditions is critical. Peripheral venous catheters (CVP) are the most used devices in clinical practice, even though their positioning can result difficult, causing delay in life-support treatments with possible critical results. Ultrasounds allow you to view blood vessel in real time, for this reason they could result helpful during use. Another option for the vascular access can be intraosseous access (I.O.), by introducing a needle directly in the bone marrow cavity. This review aim is to examine what typology of vascular access is best for the drug delivery in emergency/urgency in international and national literature. METHODS: Bibliographical research was conducted by consulting the main biomedical databases through keywords and MESH terminology. In this review 21 articles published in the last 7 years have been included. They were published in English, Italian and French. RESULTS: Contraindications and complications of I.O and of ultrasound-guided CVP positioning are limited. I.O access finding attempts are as fast as CVP positioning attempts but with a higher chance of success. Furthermore, ultrasound-guided CVP insertion is more comfortable for patients, it minimizes delays in medical treatment and it guarantees a better healthcare, with high percentage of right venous catheter placement. CONCLUSIONS: Intraosseous access is recommended for severely compromised patients; the ultrasound guide is a very useful tool when peripheral vascular areas are difficult to detect with only the palpation, it would be more appropriate in situations of urgency than that of emergency.

A third mission at the Nursing Study course University of Parma. Intervention report.

BACKGROUND: The term Third Mission refers to the activities with which universities interact directly with the communities and the territory of reference, combining the objectives of the third mission with the two traditional missions: teaching and research.  These were the premises that guided the Nursing Studies Course of the University of Parma, with the goal of implementing a structured path of "Intercultural Nursing" on a demo-ethno-anthropological basis. METHODS: The path taken was divided into several phases: arrangement of moments of interaction with students; teaching activity aimed at students based on the relationship between ethno-anthropological knowledge, aspects of migration medicine and social legislation; direct meetings with representatives of some communities present in the Parma area. RESULTS: The interaction with students was achieved through meetings called "Cultural Coffee". The first meetings, in the measure of 4-5, took place in the period October-December 2013, subsequently, the same number of meetings was repeated in the following years. In 2019, two important results were achieved: the creation of an ADE (teaching chosen by the student) dedicated to multiculturality. Another activity of the "Intercultural Nursing" course involve the students with some communities in the Parma area. CONCLUSION: The results of this experience and the underlying idea that these aspects, if addressed in the basic training, can be for the professionals most expendable in the workplace, provide reasons to continue the path started. The international comparison on the intercultural skills of nurses, indicates collaboration and partnership with communities, as fundamental elements for a complete and effective assistance.

Enhanced DNA mixture deconvolution of sexual offense samples using the DEPArray™ system.

The interpretation of DNA mixtures remains a significant challenge in the analysis of forensic evidence. The ability to selectively identify, collect, and analyze single cells or groups of cells has wide implications in the analysis of forensic samples and the subsequent deconvolution of DNA mixtures, particularly in the processing and interpretation of sexual offense evidence where the deconvolution of heterogeneous sources is essential. Single cell separation technology can be used to address this mixture separation challenge, specifically using the DEPArray™ system from Menarini Silicon Biosystems. We propose that the DEPArray™ will enable enhancements to the standard workflow for forensic biology/DNA analytical laboratories. We have demonstrated that the DEPArray™ workflow will lead to fewer mixture samples, enable purification of sperm and epithelial cell fractions without the need for differential extraction, improve the amplification success rate of samples and improve the interpretation of low template DNA samples. Sperm profiles were identified in 27 of 32 DEPArray™ processed samples, with 26 of 27 (96.2%) yielding single source profiles. In contrast, single source profiles were obtained from 9 of 28 (32.1%) differentially extracted samples. The use of the DEPArray™ also eliminates the need for additional confirmatory tests for the presence of human sperm and permits direct identification of the type and number of cells being analyzed eliminating the need for qPCR-based DNA quantification.

The peopling of the last Green Sahara revealed by high-coverage resequencing of trans-Saharan patrilineages.

BACKGROUND: Little is known about the peopling of the Sahara during the Holocene climatic optimum, when the desert was replaced by a fertile environment. RESULTS: In order to investigate the role of the last Green Sahara in the peopling of Africa, we deep-sequence the whole non-repetitive portion of the Y chromosome in 104 males selected as representative of haplogroups which are currently found to the north and to the south of the Sahara. We identify 5,966 mutations, from which we extract 142 informative markers then genotyped in about 8,000 subjects from 145 African, Eurasian and African American populations. We find that the coalescence age of the trans-Saharan haplogroups dates back to the last Green Sahara, while most northern African or sub-Saharan clades expanded locally in the subsequent arid phase. CONCLUSIONS: Our findings suggest that the Green Sahara promoted human movements and demographic expansions, possibly linked to the adoption of pastoralism. Comparing our results with previously reported genome-wide data, we also find evidence for a sex-biased sub-Saharan contribution to northern Africans, suggesting that historical events such as the trans-Saharan slave trade mainly contributed to the mtDNA and autosomal gene pool, whereas the northern African paternal gene pool was mainly shaped by more ancient events.

Cytochrome P450 2C8*2 allele in Botswana: Human genetic diversity and public health implications.

Human cytochrome P450 2C8 is a highly polymorphic gene and shows variation according to ethnicity. The CYP2C8*2 is a slow drug metabolism allele and shows 10-24% frequency in Black populations. The objective of this study was to assess the prevalence of CYP2C8*2 allele in Botswana among the San (or Bushmen) and the Bantu ethnic groups. For that purpose we recruited 544 children of the two ethnicities in three districts of Botswana from primary schools, collected blood samples, extracted DNA and genotyped them through PCR-based restriction fragment length polymorphism analysis. The results demonstrated that in the San the prevalence of the CYP2C8*2 allele is significantly higher than among the Bantu-related ethnic groups (17.5% and 8.5% for San and Bantu, respectively; P=0.00002). These findings support the evidence of a different genetic background of the San with respect to Bantu-related populations, and highlight a possible higher risk of longer drug clearance or poor level of activation of pro-drugs among the San group.

Digital Sorting of Pure Cell Populations Enables Unambiguous Genetic Analysis of Heterogeneous Formalin-Fixed Paraffin-Embedded Tumors by Next Generation Sequencing.

Precision medicine in oncology requires an accurate characterization of a tumor molecular profile for patient stratification. Though targeted deep sequencing is an effective tool to detect the presence of somatic sequence variants, a significant number of patient specimens do not meet the requirements needed for routine clinical application. Analysis is hindered by contamination of normal cells and inherent tumor heterogeneity, compounded with challenges of dealing with minute amounts of tissue and DNA damages common in formalin-fixed paraffin-embedded (FFPE) specimens. Here we present an innovative workflow using DEPArray™ system, a microchip-based digital sorter to achieve 100%-pure, homogenous subpopulations of cells from FFPE samples. Cells are distinguished by fluorescently labeled antibodies and DNA content. The ability to address tumor heterogeneity enables unambiguous determination of true-positive sequence variants, loss-of-heterozygosity as well as copy number variants. The proposed strategy overcomes the inherent trade-offs made between sensitivity and specificity in detecting genetic variants from a mixed population, thus rescuing for analysis even the smaller clinical samples with low tumor cellularity.

CYP2B6 poor metaboliser alleles involved in efavirenz and nevirapine metabolism: CYP2B6*9 and CYP2B6*18 distribution in HIV-exposed subjects from Dschang, Western Cameroon.

The prescription of patients' tailored anti-infectious treatments is the ultimate goal of pharmacogenetics/genomics applied to antimicrobial treatments, providing a basis for personalized medicine. Despite the efforts to screen Africans for alleles underlying defective metabolism for a panel of different drugs, still more research is necessary to clarify the interplay between host genetic variation and treatments' response. HIV is a major infectious disease in sub-Saharan African countries, and the main prescribed anti-HIV combination therapy includes efavirenz (EFV) or nevirapine (NVP). The two drugs are both mainly metabolised by cytochrome P450 2B6 liver enzyme (CYP2B6). Defective variants of CYP2B6 gene, leading to higher drug exposure with subsequent possible side effects and low compliance, are well known. However, little is known about CYP2B6 alleles in Cameroon where only one study was done on this subject. The main objective of the present work is to assess, in a subset of HIV-exposed subjects from Dschang in West Cameroon, the prevalence of two SNPs in the CYP2B6 gene: 516G>T (rs3745274) and 983T>C (rs28399499), both associated to a defective EFV and NVP metabolism. We analyzed 168 DNA samples collected during two cross-sectional surveys performed in Dschang, West Cameroon. In the population studied the observed allele frequencies of 516G>T and 983T>C were 44.35% (95%CI, 36.84-51.86%) and 12.80% (95%CI, 7.75-17.85%), respectively. Moreover, concerning the CYP2B6 expected phenotypes, 28.57% of the population showed a poor metaboliser phenotype, while 27.38% and 44.05% showed an extensive (wild-type) and an intermediate metaboliser phenotype, respectively. Here we found that an important fraction of the subjects is carrying EFV/NVP poor metaboliser alleles. Our findings could help to improve the knowledge about the previewed efficacy of anti-HIV drug therapy in Cameroon. Finally, we designed a new method of detection for the 983T>C genetic variation that can be applied in resource-limited laboratories.

Absence of the human CYP2C8*3 allele in Ugandan children exposed to Plasmodium falciparum malaria.

Study of host pharmacogenetics can improve our knowledge of mechanisms of drug resistance selection and spread. This issue has recently been addressed with respect to chloroquine and amodiaquine in malaria endemic areas of West and East Africa. Here we report, from surveys performed in two different areas of Uganda, that the human CYP2C8*3 allele, which had been reported to be strongly associated with parasite drug resistance in Zanzibar, is absent, being a marker of genetic admixture of the Zanzibari population with a Caucasoid component. Moreover, a retrospective analysis of CYP2C8*2 and the Plasmodium falciparum drug resistant pfmdr1 86Y allele does not show any association, which may be related to the high level of drug resistance.

Distribution of human CYP2C8*2 allele in three different African populations.

BACKGROUND: The aim of this study was to investigate cytochrome P450 2C8*2 (CYP2C8*2) distribution and allele frequency in three populations from West and East Africa exposed to Plasmodium falciparum malaria. CYP2C8 enzyme is involved in the metabolism of the anti-malarials amodiaquine and chloroquine. The presence of the CYP2C8*2 defective allele has been recently associated to higher rate of chloroquine-resistant malaria parasites. METHODS: A total of 503 young subjects were genotyped for the single nucleotide polymorphism rs11572103 (A/T). Eighty-eight were from southern Senegal, 262 from eastern Uganda and 153 from southern Madagascar. The PCR-RFLP technique was used to discriminate the wild-type (A) from the defective allele (T). RESULTS: A CYP2C8*2 (T) allele frequency of 0.222 ± 0.044 was detected in Senegal, 0.105 ± 0.019 in Uganda and 0.150 ± 0.029 in Madagascar. CONCLUSIONS: This study demonstrated that CYP2C8*2 allele is widespread in Africa. This allele occurs at different frequency in West and East Africa, being higher in Senegal than in Uganda and Madagascar. These data indicate that an important fraction of the populations analysed has a decreased enzymatic activity, thus being at higher risk for drug accumulation with two possible consequences: i) an exacerbation of drug-associated adverse side effects; ii) an increase of drug-resistance selection pressure on P. falciparum parasites.

Psychological dimensions of celiac disease: toward an integrated approach.

Psychic alterations have been reported in celiac disease. Our aim was to evaluate the emotional impact of celiac disease diagnosis in adulthood, the patient/doctor relationship, and the patients' cooperation with disease treatment and diet. The patients were 114 adult celiac patients on a gluten-free diet, there were 25 untreated celiac patients. Self-administered questionnaires aimed to evaluate the patients' level of knowledge of disease, the emotional impact at diagnosis, and feelings during follow-up. Celiac patients showed good knowledge of the disease, directly correlated to their socioeconomic level (P = 0.011). At diagnosis, relief was most intense feeling (Mean +/- SD, 10.82 +/- 7.63), demographics, time latency of diagnosis, and the duration of the disease had no effect on the intensity of all feelings. The scores of the self-rated emotions were entered into a principal component analysis that generated three factors: 1 (fear, anger, anxiety and sadness), 2 (reassurance and resignation), and 3 (relief); patients judged the clinicians presenting the disease "in the right way" (F = 33.279; P < 0.0001). The right way correlated with relief and reassurance (P = 0.0009; P = 0.0008 respectively). At follow-up, anger was the predominant emotion that induced patients to transgress. A positive correlation was observed between feeling different and the sadness, anger, fear (P < 0.0001 for all). Anger was inversely correlated with actual compliance to diet (P = 0.0005). In conclusion, in adult patients, adaptive and psychological aspects must be taken into account to understand the celiac patient and for better clinical management.

Caracteristicas de personalidade de 4 irmaos, adolescentes, atendidos durante uma "crise dissociativa conjunta"

Objetivou-se discutir as avaliacoes psicologicas de 4 irmaos adolescentes, atendidos no Servico de Psiquiatria do H. C. F. M. R. P., durante uma 'crise dissociativa conjunta'. Imediatamente apos essa 'crise', os 4 foram encaminhados para avaliacao psicologica, realizada concomitantemente, utilizando-se as tecnicas projetivas: HTP, Desiderativo e Rorschach. A caracterizacao da personalidade de cada um, sugeriu uma dificuldade na resolucao dos lutos proprios da adolescencia, sugestionalidade e busca conjunta de diferenciacao.