IntroductionPalliative care is an emotionally and spiritually high-demanding setting of care. The literature reports on the main issues in order to implement self-care, but there are no models for the organization of the training course. We described the structure of training on self-care and its effects for a Hospital Palliative Care Unit.MethodWe used action-research training experience based mostly on qualitative data. Thematic analysis of data on open-ended questions, researcher’s field notes, oral and written feedback from the trainer and the participants (...) on training outcomes and satisfaction questionnaires were used.ResultsFour major themes emerged: “Professional role and personal feelings”; “Inside and outside the team”; “Do I listen to my emotions in the care relationship?”; “Death: theirs vs. mine.” According to participants’ point of view and researchers’ observations, the training course resulted in ameliorative adjustments of the program; improved skills in self-awareness of own’s emotions and sharing of perceived emotional burden; practicing “compassionate presence” with patients; shared language to address previously uncharted aspects of coping; allowing for continuity of the skills learned; translation of the language learned into daily clinical practices through specific facilitation; a structured staff’s support system for emotional experiences.DiscussionSelf-care is an important enabler for the care of others. The core of our intervention was to encourage a meta-perspective in which the trainees developed greater perspicacity pertaining to their professional role in the working alliance and also recognizing the contribution of their personal emotions to impasse experienced with patients. (shrink)

Whitehead, in his famous book "Process and Reality", proposed a definition of point assuming the concepts of “region” and “connection relation” as primitive. Several years after and independently Grzegorczyk, in a brief but very interesting paper proposed another definition of point in a system in which the inclusion relation and the relation of being separated were assumed as primitive. In this paper we compare their definitions and we show that, under rather natural assumptions, they coincide.

Whitehead, in his famous book Process and Reality, proposed a definition of point assuming the concepts of "region" and "connection relation" as primitive. Several years after and independently Grzegorczyk, in a brief but very interesting paper, proposed another definition of point in a system in which the inclusion relation and the relation of being separated were assumed as primitive. In this paper we compare their definitions and we show that, under rather natural assumptions, they coincide.

IntroductionDignity therapy is brief psychotherapy targeting psychological and existential suffering among patients with a life-limiting illness. Studies have been conducted on the use of DT by healthcare professionals. In Italy, the current legislation defines that any form of psychotherapy may be performed exclusively by psychotherapists. Consequently, this intervention is unlikely to be used by other healthcare professionals. Herein, we will describe a training on DT not as a psychotherapy intervention but as a narrative intervention for non-psychotherapists health care professionals. Finally, (...) we will explore the potential enablers/barriers as experienced by palliative care physicians and nurses.MethodsThe study was conducted in the Psycho-Oncology Unit within the Cancer Research Hospital of Reggio Emilia. It consisted of an exploratory qualitative case study. Data were collected employing observations and interview data and thematically analyzed.ResultsThe training was attended by six physicians and ten nurses and took place during two-afternoon sessions for 10 h. Two participants put their training into practice and administered DT under the supervision of a psychotherapist. Data analysis highlighted five overarching themes relating to the training experience and direct use of DT, namely, time required, psychological skills, patient’s disease awareness, patient’s life history, and distinguishing DT from Advance Care Planning.ConclusionPalliative care professionals found DT to be a valuable non-pharmacological hospital-based intervention to address the person beyond the patient and his clinical conditions. In our experience, considering that in Italy, psychotherapy is an intervention that psychotherapists can only perform, it can help organize different training on DT for psychotherapists and other healthcare professionals. (shrink)

In the last decade, the financial underground markets evolved in a surprisingly way, around the world. Eastern Europe is a significant region, where illegal activities associated with the shadow economy became a real problem that affects the governments stability, the economical, political and social status. Due to the influence of old regimes and the current tolerance of the Eastern European nations, this underground corridors emphasize the risk of interfering with the financing platforms of international terrorism or organized crime.

This paper is about a special version of PDL, proposed by Marcus Kracht, for reasoning about sibling ordered trees. It has four basic programs corresponding to the child, parent, left- and right-sibling relations in such trees. The original motivation for this language is rooted in the field of model-theoretic syntax. Motivated by recent developments in the area of semi-structured data, and, especially, in the field of query languages for XML (eXtensible Markup Language) documents, we revisit the language. This renewed interest (...) comes with a special focus on complexity and expressivity aspects of the language, aspects that have so far largely been ignored. We survey and derive complexity results, and spend most of the paper on the most important open question concerning the language: what is its expressive power? We approach this question from two angles: Which first-order properties can be expressed? And which second-order properties? While we are still some way from definitive answers to these questions, we discuss two first-order fragments of the PDL language for ordered trees, and show how the language can be used to express some typical (second-order) problems, like the boolean circuit and the frontier problem. (shrink)

Background:Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety.Objectives:The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute (...) to moral distress in undergraduate student nurses during their clinical experience and professional education.Research design:The research design was a systematic literature review.Method:The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check.Ethical consideration:Since this was a systematic review, no ethical approval was required.Findings:From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students’ individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses.Conclusion:Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students. (shrink)

This study investigated how gender shapes the relationships between classroom environment, achievement goals and maths performance. Seventh-grade students (N?=?498) from five urban secondary schools filled in achievement goal orientations and classroom environment scales at the beginning of the second semester. Maths performance was assessed as an average grade four months later. The results indicated gender differences in the perception of teacher and peers support, achievement goals and maths performance. The effects of goal orientations, teacher and peers support on achievement were (...) moderated by gender. Furthermore, the interaction between classroom environment and performance goals on maths grades varied with gender. In the boys? sample, performance-avoidance goals interacted with teacher support, while in the girls? sample, performance-approach goals interacted with peers support in predicting maths grades. The educational implications of these gender differences are discussed. (shrink)

A main identifying factor of professions is professionals' willingness to comply with ethical and professional standards, often defined in a code of ethics and conduct. In a period of intense nursing mobility, if the public are aware that health professionals have committed themselves to the drawing up of a code of ethics and conduct, they will have more trust in the health professional they choose, especially if this person comes from another European Member State. The Code of Ethics and Conduct (...) for European Nursing is a programmatic document for the nursing profession constructed by the FEPI (European Federation of Nursing Regulators) according to Directive 2005/36/EC On recognition of professional qualifications , and Directive 2006/123/EC On services in the internal market, set out by the European Commission. This article describes the construction of the Code and gives an overview of some specific areas of importance. The main text of the Code is reproduced in Appendix 1. (shrink)

It is shown the complete equivalence between the theory of continuous (enumeration) fuzzy closure operators and the theory of (effective) fuzzy deduction systems in Hilbert style. Moreover, it is proven that any truth-functional semantics whose connectives are interpreted in [0,1] by continuous functions is axiomatizable by a fuzzy deduction system (but not by an effective fuzzy deduction system, in general).

The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse (...) effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices. (shrink)

Background:Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues.Research questions:‘How do correctional nurses describe their working experience in prisons? What issues emerged?’Methodology:This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data.Participants and research (...) context:Our sample included 31 correctional nurses in seven prisons in Northern Italy.Ethical considerations:The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses’ employer. Formal consent was obtained from all the nurses who volunteered to participate in this study.Findings:Five themes emerged from the focus groups: prisoners’ healthcare needs, negotiation between custody and care, satisfaction of working in prisons, obstacles to quality care and safety. ‘Manipulation’ was a transversal theme that emerged from all the focus groups.Discussion:The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care.Conclusion:In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress. (shrink)

La base conceptual de lo que sería más tarde desarrollado por las vanguardias artísticas fue colonizada por alemanes de pensamiento romántico e idealista, cuya dimensión utópica puede ser fácilmente reconocida en el «antiguo programa del idealismo alemán» (1796), un texto que consagró un pensamiento idealista, que clamó por una nueva racionalidad o una mitología de la razón de Hegel, la intuición intelectual de Schelling y la Humanidad de Schiller. Aunque este proyecto de emancipación desarrollado más tarde por la vanguardia ha (...) perdido su credibilidad para nosotros, todavía tenemos que investigar en qué medida el arte de hoy puede mantener una función social. Este artículo señala algunos conceptos idealistas a la luz de una filosofía del arte, y fue creado siguiendo las líneas esbozadas en la Crítica del juicio de Kant, que han contribuido a la historia de la «avanzada» del arte. (shrink)

A startup ecosystem is a dynamic environment in which several actors, such as investors, venture capitalists, angels, and facilitators, are the protagonists of a complex interplay. Most of these interactions involve the flow of capital whose size and direction help to map the intricate system of relationships. This quantity is also considered a good proxy of economic success. Given the complexity of such systems, it would be more desirable to supplement this information with other informative features, and a natural choice (...) is to adopt mathematical measures. In this work, we will specifically consider network centrality measures, borrowed by network theory. In particular, using the largest publicly available dataset for startups, the Crunchbase dataset, we show how centrality measures highlight the importance of particular players, such as angels and accelerators, whose role could be underestimated by focusing on collected funds only. We also provide a quantitative criterion to establish which firms should be considered strategic and rank them. Finally, as funding is a widespread measure for success in economic settings, we investigate to which extent this measure is in agreement with network metrics; the model accurately forecasts which firms will receive the highest funding in future years. (shrink)

Over the past several years, discoveries from mouse genetics have had direct impact on our understanding of vitamin A metabolism. Although the metabolism of vitamin A in the mouse does have some special features (for example very large stores of liver and pulmonary retinyl esters), the ability to construct knockout and transgenic mouse models has yielded an impressive amount of information directly relevant to understanding the general principles of vitamin A transport, storage and degradation. We discuss below the metabolism of (...) vitamin A through a number of genetically engineered mouse strains with alterations in genes that affect this metabolism. The novelty of this experimental approach is evidenced by the fact that the oldest of these strains was first reported only eight years ago.1) BioEssays 23:409–419, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

L'articolo cerca di rispondere a questo interrogativo: quali sono le conseguenze del processo di individualizzazione sui legami sociali e sulla solidarietÀ? Esso porta, come alcuni autori hanno recentemente sostenuto, alla disgregazione sociale, alla ‘fine della societÀ', o possono essere rintracciate nuove forme di ricomposizione sociale? Il soggetto ‘individualizzato' č quindi un soggetto liberato e isolato nello stesso tempo, che č divenuto il perno dei destini del mondo? L'articolo sostiene una tesi diversa. Esso mette in luce alcuni caratteri della trasformazione attuale (...) che delineano varie forme di individualismo: individualismi sociali e asociali. Si cerca di mostrare che nuove forme di regolazione sociale stanno emergendo ovunque nel mondo globale. (shrink)

This paper proposes an empirical assessment of the main factors behind the decision of a corporate sponsor to launch a socially responsible fund. Our analysis is performed on a database that encompasses 414 SR fund creations by 46 corporate sponsors between 1990 and 2012. We provide evidence that economic and human resources slack, leverage, low media coverage and high extra-financial performance of the corporate sponsor contribute to an increase of the probability to propose SR funds. These results lead us to (...) argue that the introduction of such funds goes beyond the economic objective of enlarging the market share of the corporate sponsor. It may thus be seen as a particular strategy in terms of communication and signaling, due to the specific characteristics of SR funds. (shrink)

This study evaluated how gender is related to children’s intelligence beliefs, goal orientations and academic achievement and whether there are gender differences in how intelligence beliefs and goal orientations are related to academic achievement. The participants, 362 seventh grade students, completed measures regarding their intelligence beliefs and goal orientations at the beginning of the second semester and the grades were collected at the end of the semester. Girls reported higher scores on incremental belief, mastery goal and higher achievement but lower (...) levels of performance avoidance compared to boys. The relations between intelligence beliefs and academic achievement were fully mediated by both performance goals. Further, there were no gender differences in the associations among intelligence beliefs, goal orientations and achievement. The findings reveal that goal orientations are a mechanism that might explain why intelligence beliefs are l... (shrink)

What is the relation of risk to negativity? Is it possible to think a notion of the negative that doesn't exclude the other via inclusion? These two questions are at the heart of Massimo Donà's discussion of immunity. Drawing on Roberto Esposito's genealogy of immunity in community, Donà shows how immunity depends upon a paradox of separation that brings the common and the immune closer together. After sketching the relation of immunity to the notion of polemos, Donà argues that the (...) immune subject, by including the other, negates itself so that the other becomes the true self. The essay closes with a series of reflections on how to think negation and immunity together through pregnancy; a negation that affirms a nonsubstitutive or alternative way of being. (shrink)