Quality of work experience after angioplasty or heart surgery: a monocentric cohort study.

PURPOSE: The study evaluated work experience changes and its determinants after return to work (RTW) in angioplasty or heart surgery patients. METHODS: During a 1-year period (2014) in a Rehabilitation Hospital in northwestern Italy, we approached 253 patients (19.3% of inpatients). 199 patients consented to complete a survey on job characteristics, job satisfaction, job involvement, illness perception, depression, anxiety, adherence to therapy, and sociodemographic characteristics. The data were analysed with paired sample t tests and random intercept regression models. RESULTS: 156 patients completed both the baseline and the 6-month follow-up assessments. After 6 months, 137 (88%) patients return to work (86% male, M age = 51.9 ± 8.1). The patients predominantly underwent angioplasty/bypass (46%) or valve replacement/repair (38%). Work hours (WO), job satisfaction (JS), and job involvement (JI) significantly decreased after RTW (WO: t (132) = 2.07, p < 0.05; JS: t (134) = 2.56, p < 0.05; JI: t (129) = 4.14, p < 0.001). The decrease in work hours over time was associated with a within-subjects decrease in psychological job demands (ß = 5.107, t (112.1) = 2.21, p < 0.05) and job satisfaction (ß = 2.498, t (112.92) = 2.265, p < 0.05) and an increase in physical job demands (ß = - 1.314, t (112.07) = - 2.416, p < 0.05). The decrease in job satisfaction over time was related to a within-subjects decrease in decision latitude (ß = 0.505, t (116.43) = 2.825, p < 0.01) and an increase in psychological job demand (ß = - 0.586, t (116.78) = - 3.141, p < 0.01). The decrease in job involvement over time was associated with a decrease in physical job demands (ß = 0.063, t (117.19) = 2.157, p < 0.05) within-subjects. CONCLUSIONS: The study showed that many patients who RTW after angioplasty or heart surgery have poorer work experiences relative to changes in psychological and physical demands and more passive roles.

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper.

Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on 'new' conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.

Cardiac Prevention and Rehabilitation "3.0": From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR).

Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Once centered on the acute phase, aimed primarily at short-term survival, the healthcare of cardiac patients now increasingly involves the chronic phase where the challenge is to guarantee continuity and quality of care in the medium and long-term. The aim of the present position paper is to provide the state-of-the-art of CR in Italy, discussing its trengths and weaknesses as well as future perspectives.

ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic-therapeutic pathway in Italy.

Atherosclerotic cardiovascular disease still represents the leading cause of death in Western countries. A wealth of scientific evidence demonstrates that increased blood cholesterol levels have a major impact on the outbreak and progression of atherosclerotic plaques. Moreover, several cholesterol-lowering pharmacological agents, including statins and ezetimibe, have proved effective in improving clinical outcomes. This document focuses on the clinical management of hypercholesterolaemia and has been conceived by 16 Italian medical associations with the support of the Italian National Institute of Health. The authors discuss in detail the role of hypercholesterolaemia in the genesis of atherosclerotic cardiovascular disease. In addition, the implications for high cholesterol levels in the definition of the individual cardiovascular risk profile have been carefully analysed, while all available therapeutic options for blood cholesterol reduction and cardiovascular risk mitigation have been explored. Finally, this document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolaemia.

Italian Survey on Prevalence and Disease Management of Chronic Heart Failure and Chronic Obstructive Pulmonary Disease comorbidity in ambulatory patients. SUSPIRIUM study rationale and design.

BACKGROUND: Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Through shared risk factors and pathophysiological mechanisms, CHF and COPD frequently coexist. The concurrent disease has important therapeutic implications and independently predicts worsened mortality, impaired functional status, and health service use. However, assessment of the comorbidity varies widely according to the population studied, diagnostic criteria and measurement tools applied. Both syndromes have been studied extensively but largely separately, mostly in the domain of the pulmonologist for COPD and in the domain of the cardiologist for CHF. STUDY OBJECTIVES AND DESIGN: The aim of the study is to evaluate in an Italian outpatients setting (10 cardiology and 10 pulmonology centers from the same institution) the prevalence, clinical profile and the routine diagnostic, functional and therapeutic work-up applied by cardiologists and pulmonologists in the presence/suspicion of concurrent disease in patients in a stable phase of their disease. For this purpose, CHF and COPU outpatients will be enrolled in a multicenter, nationwide, prospective observational study. Risk estimation of comorbidity will be based on suspected, documented or patient-reported diagnosis of COPD/CHF. In the absence of documented concurrent diagnosis, each specialist will describe the diagnostic, functional and therapeutic work-up applied. CONCLUSION: The design of the study focused on the diagnostic validation of the CHF-COPD comorbidity aims to provide relevant new information on the assessment of the coexistent condition in the cardiac and pulmonary outpatients setting and on specialty-related different diagnostic and therapeutic strategies of comorbidity utilized in real life clinical practice. The symptomatic and prognostic benefits resulting from a combined approach to CHF/COPD could outweigh those attainable by treating either condition alone.

[First definition of minimal care model: the role of nurses, physiotherapists, dietitians and psychologists in preventive and rehabilitative cardiology]. / Documento preliminare alla definizione degli interventi Minimal Care infermieristici, fisioterapici, dietistici e psicologici attuabili nell'ambito della Cardiologia Riabilitativa e Preventiva.

Rehabilitative and preventive cardiology (CRP) is configured as intervention prevention to "gain health" through a process of multifactorial care that reduces disability and the risk of subsequent cardiovascular events. It makes use of an interdisciplinary team in which every professional needs to have multiple intervention paths because of the different levels of clinical and functional complexity of cardiac patients who currently have access to the rehabilitation. The document refers to the use of interventions by nurses, physiotherapists, dietitians and psychologists that are part of the rehabilitation team of CRP. Interventions of which have been documented, on scientific bases and clinical practice, empirical effectiveness and organizational efficiency. The methodological approach of this paper is a first attempt to define, through the model of consensus, the minimum standards for a CRP evidence based characterized by clearly defined criteria that can be used by operators of CRP. The document describes the activities to be carried out in each of the phases included in the pathways of care by nurses, physiotherapists, dietitians and psychologists. The routes identified were divided, according to the type of patients who have access to the CRP and to the phases of care, including the initial assessment, intervention, evaluation and final reporting, in high medium and low complexity. Examples of models of reporting, used by the operators of the team according to the principles of good clinical practice, are provided. This is made to allow traceability of operations, encourage communication inside the working group and within the patient and the caregiver. Also to give any possible indication for the post-rehabilitation.

[Management of patients with type 2 diabetes during cardiac prevention and rehabilitation. An expert opinion from the Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P)]. / La gestione del paziente con diabete di tipo 2 in Cardiologia Preventiva e Riabilitativa. Expert opinion della Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P).

Patients with diabetes, regardless of their cardiovascular disease and their index event, are more and more often referred to Cardiac Rehabilitation Units. These patients usually show high or very high cardiovascular risk, marked disability and poor quality of life. Furthermore, those with older age, frailty, and female sex have even more rehabilitative needs, thus requiring fine individualized approaches. Consequently, in order to identify their therapeutic goals, the glycemic target should be pursued together with the effective reduction of the global cardiovascular risk. Modern exercise protocols are based on the synergic effect of both aerobic and strength training of moderate and high effort intensities, in order to achieve improvements of cardiorespiratory fitness and glycemic values as well. Exercise training and nutritional intervention are strictly related during the rehabilitation program, thus promoting better lifestyle in the long term too. New antidiabetic drugs (such as sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists) should be included into a specific "patient journey" along with other core components of the rehabilitation program. Therefore, the active role of all allied professionals (namely nurses, physiotherapists, dietitians and psychologists) is essential to the success of the cardiometabolic team. Diabetes should be routinely included in the outcome evaluation of cardiac rehabilitation programs and in every follow-up plan through a successful crosstalk among cardiologists, diabetologists and patients.

[ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): temporary report of the first prospective, longitudinal registry of the cardiac rehabilitation network GICR/IACPR]. / ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): primo bilancio di una grande esperienza scientifica del network riabilitativo GICR/IACPR.

The Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization (ICAROS) was a multicenter, prospective, longitudinal survey carried out by the Italian Association on Cardiovascular Prevention and Rehabilitation (GICR/IACPR) in patients on completion of a CR program after coronary artery by pass grafting (CABG) and percutaneous coronary intervention (PCI). The aim was to evaluate in the short and medium-term: i) the cardioprotective drug prescription, modification and adherence; ii) the achievement and maintenance of recommended lifestyle targets and risk factor control and their association with cardiovascular events; iii) the predictors of non-adherence to therapy and lifestyle recommendations. The ICAROS results offers a portrait of the "real world" of clinical practice concerning patients after CABG and PCI, and stresses the need to improve secondary prevention care after the index event: many patients after revascularization leave the acute wards without an optimal prescription of preventive medication but the prescription of cardiopreventive drugs and risk factors control is excellent after completion of a CR program. Following CR, the maintenance of evidence-based drugs and lifestyle adherence at one year is fairly good as far as the target goals of secondary prevention are concerned, but to investigate the influence of CR on long-term outcome longer-term studies are required. Last, but not least, ICAROS shows that some characteristics (PCI as index event, living alone, poor eating habits or smoking in young age, and old age, in particular with comorbidities) may identify patients with poor behavioral modification in the medium-term follow-up and in these patients further support may be warranted. In conclusion, participation in CR results in excellent treatment after revascularization, as well as a good lifestyle and medication adherence at 1 year and provides further confirmation of the the benefit of secondary prevention.

[Standards and outcome measures in cardiovascular rehabilitation. Position paper GICR/IACPR]. / Requisiti e indicatori in cardiologia riabilitativa: documento di consenso del GICR/IACPR.

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic problem in Italy. Costs and resources required are increasing in close correlation to both the improved quality of care and to the population ageing. There is an overwhelming evidence of the efficacy of cardiac rehabilitation (CR) in terms of reduction in morbidity and mortality after acute cardiac events. CR services are by definition multi-factorial and comprehensive. Furthermore, systematic analysis and monitoring of the process of delivery and outcomes is of paramount importance. The aim of this position paper promoted by the Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) is to provide specific recommendations to assist CR staff in the design, evaluation and development of their care delivery organization. The position paper should also assist health care providers, insurers, policy makers and consumers in the recognition of the quality of care requirements, standards and outcome measure, quality and performance indicators, and professional competence involved in such organization and programs. The position paper i) include comprehensive CR definition and indications, ii) describes priority criteria based on the clinical risk for admission to both inpatient or outpatient CR, and iii) defines components and technological, structural and organizing requirements for inpatient or outpatient CR services, with specific indicators and standards, performance measures and required professional skills. A specific chapter is dedicated to the requirements for highly specialized CR services for patients with more advanced cardiovascular diseases.

The Bugs in the Bags: The Risk Associated with the Introduction of Small Quantities of Fruit and Plants by Airline Passengers.

Among European countries, Italy is the most exposed to the risk of biological invasions, principally for its numerous entry points (ports and airports) and for climatic conditions favorable for the acclimatization of several invasive species. Here it was assessed that the greatest threats to our agro-ecosystems come mainly from the passenger baggage in which a variety of fruits and vegetables are carried. From 2016 to 2021, large quantities of plant products were found in the luggage of passengers travelling from outside the EU and seized at the BCPs (border control posts) in the Campania region. Inspections and the following laboratory analyses were conducted on the plant material to assess the presence of exotic pests. Inspections led to several non-native species being recorded, and among the intercepted organisms, some should be considered "alarming", such as Bactrocera dorsalis, Anastrepha obliqua, and Leucinodes africensis. Despite a well-organized border inspection system, travelers transporting infested material unknowingly contribute to increasing the risk of the introduction of exotic species. Given the current situation, it is necessary to impose stricter controls and greater attention, ensuring compliance with the requirements of the new phytosanitary regulations by the actors involved in the transport of plant material. Finally, it is essential to improve awareness through a phytosanitary campaign on plant health risks, especially for people wishing to transport fruits and vegetables in their luggage.

[Selection criteria for referral to in-hospital intensive cardiac rehabilitation after transcatheter aortic-valve implantation]. / Proposta di criteri di accesso alla degenza riabilitativa cardiologica dopo impianto transcatetere di valvola aortica.

Transcatheter aortic valve implantation (TAVI) is assuming a major role in the routine management of patients with aortic stenosis. There is a paucity of data to substantiate the referral of these patients to in-hospital intensive cardiac rehabilitation, widely recognized as the standard of care for cardiac patients in the post-acute phase. The patients considered to be candidates for TAVI were at high risk, defined by Euroscore > 20% or STS score > 10%, mainly because they had coexisting comorbidities, with high care and rehabilitative needs. Reasonable selection criteria for referral were: trans-apical approach, past history of heart failure or coronary artery disease, advanced therapy needs (e.g. ventilatory, inotropic, nutritional), worsening comorbidities, logistic or social problem, frailty, and need of educational and lifestyle support.

[Assessing patients needs in outpatients with advanced heart failure]. / Analisi dei bisogni assistenziali in ambito domiciliare del paziente con scompenso cardiaco avanzato.

BACKGROUND: Because of the progressive ageing of the population and the extensive use of recommended drugs, the number of patients with advanced heart failure (AHF) constantly increases. AHF is the most common cause of acute hospital admission. The outcome and quality of life are generally poor for repeated hospital readmission. OBJECTIVE: To assess a mixed method approach: face-to-face semi-structured qualitative interview incorporating quantitative analysis of demographic data and qualitative exploration of perception of needs in outpatients AHF, plus Barthel score [BS], Short Portable Mental Status Questionnaire [SPMSQ] and Moriski Medication Adherence Scale [MS]). METHODS: Longitudinal prospective study in 50 elderly (age > 75 years) patients with AHF (stage C and D AHA/ACC plus almost two hospital admission in the last 12 months with main diagnosis of HF). Patients and caregivers were asked what they considered to be their main needs, including social support and the provision of practical care, psychological support; and information and choice. In the same time, BS, SPMSQ and MS were delivered. MAIN RESULTS: The main areas of needs identified by patients were knowledge of available social and health services (80%) and disease and lifestyle habits (respectively 66% and 72% of patients), clear identification of the care-manager (70%), awareness of alarm and worsening symptoms (60%). Patients experienced difficulty in communication and information exchange, and fragmented co-ordination between social and care services was identified. The quality of life was generally poor for repeated hospital readmission, mainly for poor adherence to drugs and lifestyle, lacking attention to new onset or worsening symptoms, no planning of hospital discharge and for inadequate social support. CONCLUSIONS: The semi-structured interview is a useful tool to identify the patient information and educational needs. The main care needs identified by advanced HF outpatients relate to the everyday social and practical aspects of care. There is a need to reform the delivery of care to address the educational and lifestyle support.

Development of a loop-mediated isothermal amplification (LAMP) assay for the identification of the invasive wood borer Aromia bungii (Coleoptera: Cerambycidae) from frass.

The red-necked longhorn beetle Aromia bungii (Faldermann, 1835) (Coleoptera: Cerambycidae) is native to east Asia, where it is a major pest of cultivated and ornamental species of the genus Prunus. Morphological or molecular discrimination of adults or larval specimens is required to identify this invasive wood borer. However, recovering larval stages of the pest from trunks and branches causes extensive damage to plants and is timewasting. An alternative approach consists in applying non-invasive molecular diagnostic tools to biological traces (i.e., fecal pellets, frass). In this way, infestations in host plants can be detected without destructive methods. This paper presents a protocol based on both real-time and visual loop-mediated isothermal amplification (LAMP), using DNA of A. bungii extracted from fecal particles in larval frass. Laboratory validations demonstrated the robustness of the protocols adopted and their reliability was confirmed performing an inter-lab blind panel. The LAMP assay and the qPCR SYBR Green method using the F3/B3 LAMP external primers were equally sensitive, and both were more sensitive than the conventional PCR (sensitivity > 103 to the same starting matrix). The visual LAMP protocol, due to the relatively easy performance of the method, could be a useful tool to apply in rapid monitoring of A. bungii and in the management of its outbreaks.

Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up.

BACKGROUND: Long-term effects of Coronavirus Disease of 2019 (COVID-19) are of utmost relevance. We aimed to determine: 1) the functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET); 2) the characteristics associated with cardiopulmonary exercise testing (CPET) performance; 3) the safety and tolerability of CPET. METHODS: We prospectively enrolled consecutive patients with laboratory-confirmed COVID-19 from Azienda Sanitaria Locale 3, Genoa. Three months after hospital discharge a complete clinical evaluation, trans-thoracic echocardiography, CPET, pulmonary function tests, and dominant leg extension (DLE) maximal strength measurement were performed. RESULTS: From the 225 patients discharged alive from March to November 2020, we excluded 12 incomplete/missing cases and 13 unable to perform CPET, leading to a final cohort of 200. Median percent-predicted peak oxygen uptake (%pVO2) was 88% (78.3-103.1). Ninety-nine (49.5%) patients had %pVO2 below, whereas 101 (50.5%) above the 85% predicted value. Among the 99 patients with reduced %pVO2, 61 (61%) had a normal anaerobic threshold: of these, 9(14.8%) had respiratory, 21(34.4%) cardiac, and 31(50.8%) non-cardiopulmonary reasons for exercise limitation. Inerestingly, 80% of patients experienced at least one disabling symtpom, not related to %pVO2 or functional capacity. Multivariate linear regression showed percent-predicted forced expiratory volume in one-second(ß = 5.29,p = 0.023), percent-predicted diffusing capacity of lungs for carbon monoxide(ß = 6.31,p = 0.001), and DLE maximal strength(ß = 14.09,p = 0.008) to be independently associated with pVO2. No adverse event was reported during or after CPET, and no involved health professional developed COVID-19. CONCLUSIONS: At three months after discharge, about 1/3rd of COVID-19 survivors show functional limitations, mainly explained by muscular impairment, calling for future research to identify patients at higher risk of long-term effects that may benefit from careful surveillance and targeted rehabilitation.

[Clinical and organizational evidence of the efficacy and effectiveness from cardiac rehabilitation: an update]. / La Riabilitazione Cardiologica: dall'appropriatezza clinica a quella organizzativa. Aggiornamento e revisione critica della letteratura e proposte operative.

The increasing evidence on the favourable cost/effectiveness impact of the comprehensive cardiac rehabilitation program for the treatment of a wide spectrum of cardiovascular conditions have imposed to healthcare services a major attention on a critical analysis of the results in different clinical indications and delivery organisations. The Regional Health Agency of Liguria, in the occasion of drawing up regional guidelines directed to define the clinical indications and the effectiveness of the cardiac rehabilitation delivery model (in-patients, out-patients and home-based) and its requisites, indications and procedures, has updated the reference guidelines (PLNG and SIGN) with the evidence provided by the more recent literature, focusing its attention on the clinical and, in particular, organizational effectiveness. The document, on the base of these evidences, provides some effective proposals and some organizational advices.

Scanning Electron Microscopy of the Antennal Sensilla and Their Secretion Analysis in Adults of Aromia bungii (Faldermann, 1835) (Coleoptera, Cerambycidae).

BACKGROUND: It has been proved that chemical signals play an important role in mating location and reproductive behavior in cerambycids; moreover, they rely on contact chemoreception for mate recognition. METHODS: Adult antennae of Aromia bungii were observed using scanning electron microscopy and adult antennal secretions were collected and analyzed with gas chromatography-mass spectrometry. RESULTS: Twelve different types of sensilla were morphologically described on the antennae of A. bungii. At least six mechanoreceptors-one gustative, one putative chemo- or thermoreceptor, and three multiporous olfactory receptors-are present on the antennae of both sexes while a receptor-type of unclear function is limited to males. Secretions associated with sensilla basiconica were observed for the first time in a cerambycid species. CONCLUSIONS: Sensilla basiconica should play a role in odor perception detecting host tree volatiles and/or pheromones. Sensilla basiconica type 1 and 2 produce a viscous material accumulating on the antennal surface. Chemical analysis of adult antennal secretions highlighted marked differences between sexes. Some of the identified compounds have been previously reported as contact pheromone components of other cerambycid species. Our observations strongly suggest sensilla basiconica as the production sites of compounds involved in mate recognition.

Electroantennographic Responses of Aromia bungii (Faldermann, 1835) (Coleoptera, Cerambycidae) to a Range of Volatile Compounds.

BACKGROUND: The red-necked longhorn beetle, Aromia bungii, is one of the most damaging pests of stone fruit trees. Native to the south-eastern Palearctic and Oriental regions, it invaded and is established to some extent in the Campania Region (Southern Italy). In several cerambycid species, volatile organic compounds (VOCs) have been shown to play a role in mate and host plant location. METHODS: The electroantennographic (EAG) technique was employed to explore the antennal chemoreceptivity of male and female A. bungii antennae to 90 VOCs. RESULTS: Increasing EAG amplitudes from the basal to the distal antennal segments were recorded in response to six selected plant volatiles. From the distal flagellomeres, the largest EAG responses (>0.8 mV) were elicited by 2-hexanol, octanal, sulcatone, guaiacol, sulcatol, 2,4-dimethyl-3-hexanol, 2,4-dimethyl-2-hexanone, heptanal, nonanal, (Z)-3-hexenol, and 1-heptanol in both sexes, and by linalool, (E)-2-heptenal, 1-octen-3-ol, (E)-2-octenal, 3-octanol, (E)-2-octen-1-ol, α-phellandrene, and α-terpinene in males. The olfactory system of both sexes proved to be sensitive to changes in stimulus concentration and compound structure. CONCLUSIONS: this study demonstrates the capability of A. bungii males and females to detect and discriminate among a wide range of VOCs and provides a basis for further olfactometer and field trapping experiments aimed at identifying behaviorally-active compounds useful for the implementation of semiochemical-based control strategies for this pest.

Italian survey on cardiac rehabilitation and secondary prevention after cardiac revascularization: ICAROS study. A survey from the Italian cardiac rehabilitation network: rationale and design.

In this paper, the Italian Association for Cardiac Prevention and Rehabilitation (GICR) presents the rationale and design of the "Italian survey on CArdiac RehabilitatiOn and Secondary prevention after cardiac revascularization (ICAROS)". The survey is a prospective, longitudinal, multicentric survey, with a on-line web-based data collection. Its design corresponds to the survey's goal, i.e. to describe accurately in the Italian cardiological setting, through a representative number of cardiac rehabilitation centers belonging to the GICR national network, the characteristics, content and effects in the medium term of cardiac rehabilitation (CRP) inpatient or outpatient programs offered to patients after coronary artery bypass (CABG) or percutaneous revascularization (PTCA). The primary aims of the study are: a) to define the principal clinical characteristics of patients who have undergone PTCA or CABG and have been admitted to a CRP program; b) to identify the components of the CRP programs in terms of diagnostic procedures and assessment tests performed, treatments administered, educational programs and physical exercise interventions employed; c) to identify and analyze drug treatments prescribed at discharge from the acute facility and those prescribed at the end of the CRP program; d) to verify the clinical outcome during the course of the CRP program and at 6 months and 1 year after the end of the post-acute CRP program, as well as patients' adherence to the prescribed pharmacological therapy and to the recommended life styles, and the achievement and maintenance of the targets in relation to the modifiable risk factors; e) to define the consumption of major healthcare resources (major cardiac events, hospital re-admission, emergency care access, specialist visits) during the first year following a CRP program. The survey population will consist of all patients consecutively discharged in the period November 3-30, 2008 at the end of an inpatient, day-hospital or outpatient CRP programme after CABG (isolated or associated to valve or ascending aorta surgery) or PTCA (rescue, primary or elective). There are no age, sex or other patient selection criteria. Based on ISYDE 2008 data analysis, we plan to recruit approximately 1300-1400 patients, 75% of whom with post CABG diagnosis and 25% with post PTCA diagnosis. Preliminary results of the survey are expected in the late winter 2009.

The Italian Survey on Cardiac Rehabilitation-2008 (ISYDE-2008). Part 3. National availability and organization of cardiac rehabilitation facilities. Official report of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (IACPR-GICR).

From January 28th to February 10th 2008, the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (IACPR-GICR) conducted the ISYDE-2008 study, the primary aim of which was to take a detailed snapshot of cardiac rehabilitation (CR) provision in Italy--in terms of number and distribution of facilities, staffing levels, organization and setting--and compare the actual CR provision with the recommendations of national guidelines for CR and secondary prevention. The secondary aim was to describe the patient population currently being referred to CR and the components of the programs offered. Out of 190 cardiac rehabilitation centers existing in Italy in 2008, 165 (87%) took part in the study. On a national basis, there is one CR unit every 299,977 inhabitants: in northern Italy there is one CR unit every 263,578 inhabitants, while in central and southern Italy there is one every 384,034 and 434,170 inhabitants, respectively. The majority of CR units are located in public hospitals (59%), the remainder in privately owned health care organizations (41%). Fifty-nine percent are located in hospitals providing both acute and rehabilitation care, 32% are in specifically dedicated rehabilitation structures, while 8% operate in the context of residential long term care for chronic conditions. Almost three-quarters of CR units currently operating are linked to dedicated cardiology divisions (74%), 5% are linked to physical medicine and rehabilitation divisions, 2% to internal medicine, and 19% to cardiac surgery and other divisions. Inhospital care is provided by 62.4% of the centers; outpatient care is provided on a day-hospital basis by 10.9% of facilities and on an ambulatory basis by 20%. The CR units are led in 86% of cases by a cardiologist and in only 14% of cases by specialists in internal medicine, geriatrics, physical medicine and rehabilitation, pneumology or other disciplines. In terms of staffing, each cardiac rehabilitation unit has 4.0 +/- 2.7 dedicated physicians (range 1-16, mode 2), 10.1 +/- 8.0 nurses, 3.3 +/- 2.5 physiotherapists (range 0-20; 16% of services have no physiotherapist in the rehabilitation team), 1.5 +/- 0.8 psychologists, and a dietitian (present in 62% of CR units). Phase II CR programs are available in 67.9% of cases in residential (inpatient) and in 30.9% of cases in outpatient (day-hospital and ambulatory) settings. Phase III programs are offered by 56.4% of the centers in ambulatory outpatient regime, and on an at home basis by 4.8% with telecare supervision, 7.3% without. Long term secondary prevention follow up programs are provided by 42.4% of CR services.