Traceability of 'Limone di Siracusa PGI' by a multidisciplinary analytical and chemometric approach.

Food traceability is increasingly relevant with respect to safety, quality and typicality issues. Lemon fruits grown in a typical lemon-growing area of southern Italy (Siracusa), have been awarded the PGI (Protected Geographical Indication) recognition as 'Limone di Siracusa'. Due to its peculiarity, consumers have an increasing interest about this product. The detection of potential fraud could be improved by using the tools linking the composition of this production to its typical features. This study used a wide range of analytical techniques, including conventional techniques and analytical approaches, such as spectral (NIR spectra), multi-elemental (Fe, Zn, Mn, Cu, Li, Sr) and isotopic ((13)C/(12)C, (18)O/(16)O) marker investigations, joined with multivariate statistical analysis, such as PLS-DA (Partial Least Squares Discriminant Analysis) and LDA (Linear Discriminant Analysis), to implement a traceability system to verify the authenticity of 'Limone di Siracusa' production. The results demonstrated a very good geographical discrimination rate.

Intestinal protozoa in HIV-infected patients: effect of rifaximin in Cryptosporidium parvum and Blastocystis hominis infections.

In HIV-1 infected patients severe enteritis and chronic diarrhea are often documented as a consequence of multiple opportunistic infections. We analyzed 48 HIV-1 positive patients for the presence of intestinal pathogenic protozoa. Patients with CD4 > or = 200/mm3 showed a higher prevalence of a single pathogenic protozoa than patients with CD4 < or =200/mm3, who showed the presence of multiple protozoal infections. Patients who proved positive for only a single protozoa, Cryptosporidium or Blastocystis, were also positive, by stool culture, for the presence of Proteus mirabilis (3 samples), Citrobacter freundii (3 samples), Escherichia coli (one sample) or Enterobacter cloacae (one sample). Treatment with rifaximin (600 mg, 3 times a day, for 14 days) was efficacious in resolving the clinical symptoms and clearing protozoan infections in HIV-1 infected patients with CD4 > or = 200/mm3, who presented enteric and systemic symptoms due to Criptosporidium or Blastocystis associated with enteropathogenic bacteria.

Attitudes and beliefs regarding spiritual care. A survey of cancer nurses.

Why nurses neglect spiritual care issues remains unclear. Therefore, a questionnaire designed to assess oncology nurse clinicians' attitudes and beliefs about spiritual care was mailed to a stratified, random sample of 700 Oncology Nursing Society members within the United States. Data from the 181 respondents were analyzed using descriptive and multivariate statistics (for quantitative items) and content analysis (for essay questions). Analysis of data revealed both a positive regard for spiritual care within nursing, and relationships between beliefs and attitudes about spiritual care and self-reported spiritually, religiosity, ethnicity, work role, and education. Recommendations are for inclusion of theoretical and practical aspects of spiritual care in nursing education and for further investigation of nurses' attitudes and beliefs regarding spiritual care.

Spiritual care practices of oncology nurses.

PURPOSE/OBJECTIVES: To determine what spiritual care practices oncology nurses use. DESIGN: Descriptive, cross-sectional survey. SETTING: Variety of oncology clinical settings from all regions of the United States. SAMPLE: Stratified, random sampling of Oncology Nursing Society members who identified themselves as clinicians; 181 out of 700 completed the questionnaires; respondents typically were Christian, caucasian, female, adult inpatient oncology staff nurses. METHODS: Oncology Nurse Spiritual Care Perspectives Survey and a demographic form were delivered and returned through mailing; questionnaires required up to two hours for completion; respondents were given one month to complete the questionnaires. MAIN RESEARCH VARIABLES: Spiritual care practices/interventions (types and frequency) and indicators of spiritual need. FINDINGS: Frequent practices included praying with patients, referring them to chaplains or clergy, providing them with religious materials, serving as a therapeutic presence, and listening and talking to them. Frequency of traditional spiritual care practices differed by variables such as self-reported spirituality, religious service attendance, ethnicity, and education. Identified indicators of spiritual need included anxiety, depression, patient requests, death issues, hopelessness, and withdrawal. CONCLUSIONS: Oncology nurses provide spiritual care in a variety of ways that often are personal and private, yet they do so infrequently and with some discomfort. Research examining relationships between spiritual care practices and demographic variables is needed. IMPLICATIONS FOR NURSING PRACTICE: Spiritual care education and resources for clinicians are needed. Data provide examples of interventions for and indicators of spiritual need.

Prospective payment and the Medicare hospice benefit.

The objective of this study was to determine the effects of very high cost patients on hospice financial status. Ten Pennsylvania hospices dually certified by Medicare were randomly selected and agreed to participate. Patient age, sex, diagnosis, length of stay and payer were fairly uniform across hospices. Payments varied by diagnosis and payer. High cost patients were irregularly found in hospices; low cost patients were commonly and regularly distributed. Every hospice had at least one high cost patient. In one, the uncompensated payment for the 6.6 percent of patients defined as high cost ($7,300 and above) would have been 14.7 percent of total annual revenues. In another, uncompensated payments for high cost patients (9.8 percent) would have accounted for 17.2 percent of revenue. In 96.3 percent of the instances patients utilized less than the Medicare Hospice Benefit maximum allowable cost ($7,300); and, 98.8 percent of the time patients stayed less than the maximum allowable length of time of 210 days. A logistic regression model found long length of stay (p < 0.0001), Medicare hospice benefit as primary payer (p < 0.0001), any hospitalization during hospice stay (p < 0.003) and cerebrovascular disease diagnosis (p < 0.02) to be significantly related to high cost. Between the time the study was planned and completed, Medicare instituted a reinsurance program allowing unused funds below the maximum allowable limit from one patient to be used for patients who exhausted their benefits. Thus, no study hospice was adversely affected by high cost patients. However, it should serve as an object lesson to Medicare in using prospective payment.(ABSTRACT TRUNCATED AT 250 WORDS)

Midwifery to the soul while the body dies: spiritual care among hospice nurses.

Because attitudes and beliefs about spiritual care have been linked with spiritual caregiving practices in previous research among non-hospice nurses, and because little is known about hospice nurses' attitudes and beliefs about spiritual care, this study explored such attitudes and beliefs among hospice nurses. Data were obtained from 641 Hospice Nurses Association members who completed the Spiritual Care Perspectives Survey and a demographic form. While respondents rather uniformly agreed that patients had spiritual needs and that it was appropriate for nurses to attend to such needs, attitudes about how a nurse should relate to patients' spirituality were variable. Education and indicators reflecting personal religiosity were associated with these hospice nurses' attitudes and beliefs about spiritual care.

Hospice in the United States. Multiple models and varied programs.

This article has reviewed the evolution of hospice care as a discrete cluster of services in the United States from the mid-1960s until the early 1980s. It describes the psychosocial conditions produced by the dominance of cure-oriented medical technology in the medical care system and the reaction to them that hospice programs have come to express. The 6 major organizational models and their minor variations have been described, as were sources and methods of reimbursement until the implementation of the Medicare Hospice Benefit. Finally, the emergence of standards of care for this new service were outlined and the development of the JCAH Hospice Standards and Accreditation mechanism was emphasized.