This article aims to present the current tourism problem in Venice and specifically to analyse how the island and the lagoon are being affected by cruise ship tourism. Made a World Heritage Site by ...UNESCO as recently as 1987, from 2016 it has become a candidate for Heritage in Danger. UNESCO has imposed an ultimatum on the capital of Veneto in order to regulate the flow of tourism and ensure the care of the future of the city. For this purpose, the different socio-cultural factors that have affected the modification of the city will be analyzed, with a primary focus on the tourism sector, such as the relevance of space, the context in a city with such a symbolic past, or the relevance of the market and current economic interests. All these factors have led to one of the most impressive cases of turistification. Amongst all these factors, cruise ship tourism is particularly influential, given Venice's location at the heart of the Mediterranean circuit. Cruises cause a great impact in cities, particularly in Venice due to its uniqueness: pollution, noise, smoke, alteration of heritage and the environment, endangerment of citizenship, architectural and cultural heritage and the environment. And at what cost? With recent changes in mind, and given the extreme situation which has come to pass, it is hoped that public awareness will lead to heavier tourism regulation -in particular for cruises- which would be a key step towards achieving inhabitable, tourist-friendly cities.
We study compartmentalization in a Mediterranean pollination network using three different analytical approaches: unipartite modularity (UM), bipartite modularity (BM) and the group model (GM). Our ...objectives are to compare compartments obtained with these three approaches and to explore the role of several species attributes related to pollination syndromes, species phenology, abundance and connectivity in structuring compartmentalization. BM could not identify compartments in our network. By contrast, UM revealed four modules composed of plants and pollinators, and GM four groups of plants and five of pollinators. Phenology had a major influence on compartmentalization, and compartments (both UM and GM) had distinct phenophases. Compartments were also strongly characterized by species degree (number of connections) and betweenness centrality. These two attributes were highly related to each other and to phenophase duration. Differences among compartments in abundance were only apparent with GM. We attribute this to the fact that abundance is strongly correlated with Degree, and the GM algorithm is particularly powerful at discriminating species based on degree. On the other hand, the role of pollination syndrome-related features in compartmentalization mosdy emerged with UM. Only UM compartments differed in corolla length and pollen production. Both UM and GM compartments differed in their pollinator spectra. We found inconsistent reciprocity between plant attributes and pollinator spectra, thus it is difficult to conclude compartments follow clear-cut syndromes. Also, both UM and GM identified a compartment composed of pollinators with long activity periods that acted as connectors, linking all compartments providing cohesiveness to the network.
The skin plays an important role in the maintenance of the human's body physiological homeostasis. It acts as a coverage that protects against infective microorganism or biomechanical impacts. Skin ...is also implied in thermal regulation and fluid balance. However, skin can suffer several damages that impede normal wound-healing responses and lead to chronic wounds. Since the use of autografts, allografts, and xenografts present source limitations and intense rejection associated problems, bioengineered artificial skin substitutes (BASS) have emerged as a promising solution to address these problems. Despite this, currently available skin substitutes have many drawbacks, and an ideal skin substitute has not been developed yet. The advances that have been produced on tissue engineering techniques have enabled improving and developing new arising skin substitutes. The aim of this review is to outline these advances, including commercially available skin substitutes, to finally focus on future tissue engineering perspectives leading to the creation of autologous prevascularized skin equivalents with a hypodermal-like layer to achieve an exemplary skin substitute that fulfills all the biological characteristics of native skin and contributes to wound healing.
ObjectivesTo systematically identify knowledge clusters and research gaps in the health-related preferences of older patients with multimorbidity by mapping current evidence.DesignEvidence map ...(systematic review variant).Data sourcesMEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Science Citation Index/Social Science Citation Index/-Expanded from inception to April 2018.Study selectionStudies reporting primary research on health-related preferences of older patients (mean age ≥60 years) with multimorbidity (≥2 chronic/acute conditions).Data extractionTwo independent reviewers assessed studies for eligibility, extracted data and clustered the studies using MAXQDA-18 content analysis software.ResultsThe 152 included studies (62% from North America, 28% from Europe) comprised 57 093 patients overall (range 9–9105). All used an observational design except for one interventional study: 63 (41%) were qualitative (59 cross-sectional, 4 longitudinal), 85 (57%) quantitative (63 cross-sectional, 22 longitudinal) and 3 (2%) used mixed methods. The setting was specialised care in 85 (56%) and primary care in 54 (36%) studies. We identified seven clusters of studies on preferences: end-of-life care (n=51, 34%), self-management (n=34, 22%), treatment (n=32, 21%), involvement in shared decision making (n=25, 17%), health outcome prioritisation/goal setting (n=19, 13%), healthcare service (n=12, 8%) and screening/diagnostic testing (n=1, 1%). Terminology (eg, preferences, views and perspectives) and concepts (eg, trade-offs, decision regret, goal setting) used to describe health-related preferences varied substantially between studies.ConclusionOur study provides the first evidence map on the preferences of older patients with multimorbidity. Included studies were mostly conducted in developed countries and covered a broad range of issues. Evidence on patient preferences concerning decision-making on screening and diagnostic testing was scarce. Differences in employed terminology, decision-making components and concepts, as well as the sparsity of intervention studies, are challenges for future research into evidence-based decision support seeking to elicit the preferences of older patients with multimorbidity and help them construct preferences.Trial registration numberOpen Science Framework (OSF): DOI 10.17605/OSF.IO/MCRWQ.
Anti-Black police brutality in the United States is not a new problem, but at least a 400-year old one. Mainstream psychology has responded to this critical racial and social justice issue by ...conceptualizing it primarily as an outcome of police officers' social cognition (e.g., threat perceptions) or implicit racial biases. Such individualistic and cognitive perspectives, however, ignore the fundamental role of anti-Black structural racism in facilitating the ability of law enforcement to terrorize, brutalize, and kill Black people with impunity. As with the media and public attention, mainstream psychology has also tended to frame acts of anti-Black police brutality as outliers, or occasional lethal and spectacular events, rather than as a broad spectrum of routine acts that structure policing and police brutality as a world for Black people in the United States. Informed by critical psychology, and the critical theoretical frameworks of critical race theory, intersectionality, and Afro-Pessimism, the goal of this article is to critically engage with the topic of anti-Black police brutality. By critically engage, we mean expose and challenge the economic, social, and material power relations that disproportionately expose Black people to police brutality; and conceptualize police brutality not as a series of aberrant incidents, but as a structure that in essence constructs and reifies Blackness and Whiteness. We also introduce the Anti-Black Police Brutality Continuum, a conceptual framework of police brutality as a broad spectrum of routine manifestations of anti-Black structural racism, and criticize mainstream psychology's deferral of a critical and transformative response to anti-Black police brutality.
Public Significance Statement
Police brutality in U.S. Black communities is one of the most critical social justice issues of our time. Although mainstream psychology has long been in the vanguard of advancing empirical knowledge about the effects of racist stereotypes, implicit racial bias, and other individual-level factors on police brutality, it has largely ignored the role of structural racism. This article challenges mainstream psychology to critically engage with the topic of anti-Black police brutality. The article also introduces the Anti-Black Police Brutality Continuum, a conceptual framework developed to increase knowledge about the non-lethal and lethal spectrum of anti-Black police brutality, and its deleterious physical and mental health implications for U.S. Black communities.
Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been reported in immune-compromised individuals and people undergoing immune-modulatory treatments. Although ...intrahost evolution has been documented, direct evidence of subsequent transmission and continued stepwise adaptation is lacking. Here we describe sequential persistent SARS-CoV-2 infections in three individuals that led to the emergence, forward transmission, and continued evolution of a new Omicron sublineage, BA.1.23, over an eight-month period. The initially transmitted BA.1.23 variant encoded seven additional amino acid substitutions within the spike protein (E96D, R346T, L455W, K458M, A484V, H681R, A688V), and displayed substantial resistance to neutralization by sera from boosted and/or Omicron BA.1-infected study participants. Subsequent continued BA.1.23 replication resulted in additional substitutions in the spike protein (S254F, N448S, F456L, M458K, F981L, S982L) as well as in five other virus proteins. Our findings demonstrate not only that the Omicron BA.1 lineage can diverge further from its already exceptionally mutated genome but also that patients with persistent infections can transmit these viral variants. Thus, there is, an urgent need to implement strategies to prevent prolonged SARS-CoV-2 replication and to limit the spread of newly emerging, neutralization-resistant variants in vulnerable patients.
IntroductionInteraction of conditions and treatments, complicated care needs and substantial treatment burden make patient–physician encounters involving multimorbid older patients highly complex. To ...optimally integrate patients’ preferences, define and prioritise realistic treatment goals and individualise care, a patient-centred approach is recommended. However, the preferences of older patients, who are especially vulnerable and frequently multimorbid, have not been systematically investigated with regard to their health status. The purpose of this evidence map is to explore current research addressing health-related preferences of older patients with multimorbidity, and to identify the knowledge clusters and research gaps.Methods and analysisTo identify relevant research, we will conduct searches in the electronic databases MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL, Social Science Citation Index, Social Science Citation Index Expanded and the Cochrane library from their inception. We will check reference lists of relevant articles and carry out cited reference research (forward citation tracking). Two independent reviewers will screen titles and abstracts, check full texts for eligibility and extract the data. Any disagreement will be resolved and consensus reached with the help of a third reviewer. We will include both qualitative and quantitative studies, and address preferences from the patients’ perspectives in a multimorbid population of 60 years or older. There will be no restrictions on the publication language. Data extraction tables will present study and patient characteristics, aim of study, methods used to identify preferences and outcomes (ie, type of preferences). We will summarise the data using tables and figures (ie, bubble plot) to present the research landscape and to describe clusters and gaps.Ethics and disseminationDue to the nature of the proposed evidence map, ethics approval will not be required. Results from our research will be disseminated by means of specifically prepared materials for patients, at relevant (inter)national conferences and via publication in peer-reviewed journals.
Aim and Objectives
To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID‐19 among Spanish nurses by comparing two assessment points: before and ...after the COVID‐19 vaccination campaign.
Background
The COVID‐19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID‐19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential.
Design
A repeated cross‐sectional design was carried out with a time‐lapse of 12 months.
Methods
A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID‐19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies.
Results
The fear of COVID‐19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID‐19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = − .16, p = .001; r = − .22, p ≤ .001).
Relevance to Clinical Practice
Programmes to reduce fear of COVID‐19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care.
Patient or Public Contribution
The nurses collaborated by participating in the present study anonymously and disinterestedly.
The immune system may mediate anti-tumor responses in chronic lymphocytic leukemia (CLL) which may affect disease progression and survival. In this study, we analyzed the immune characteristics of 99 ...consecutive previously diagnosed CLL patients and 50 healthy controls. The distribution of lymphocyte subsets at diagnosis was retrospectively analyzed. Compared with controls, leukemia patients showed an expansion of NK and CD8 T cells at diagnosis. The relative number of CD8 T cells at diagnosis was associated with time to treatment, suggesting that CD8 T cells may modify disease progression. The distribution of lymphocyte subsets was analyzed again when patients were enrolled in this study. The median time since these patients were diagnosed was 277 weeks. Compared with diagnosis, the absolute number of CD8 T cells significantly decreased in these patients, reaching similar values to healthy controls; however NK cells kept significantly elevated overtime. Nevertheless, NK cells showed an impaired expression of NKG2D receptor and a defective cytotoxic activity. This down-regulation of NKG2D expression was further enhanced in patients with advanced and progressive disease. Additionally, membrane NKG2D levels significantly decreased on CD8 T cells, but a significant increase of NKG2D+CD4+ T cells was observed in CLL patients. The cytotoxic activity of NK cells was diminished in CLL patients; however the treatments with IL-2, IL-15, IL-21 and lenalidomide were able to restore their activity. The effect of IL-2 and IL-15 was associated with the increase of NKG2D expression on immune cells, but the effect of IL-21 and lenalidomide was not due to NKG2D up-regulation. The expansion of NK cells and the reversibility of NK cell defects provide new opportunities for the immunotherapeutic intervention in CLL.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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