Indian nurses in Italy: a qualitative study of their professional and social integration

AIMS AND OBJECTIVES: To investigate the lived subjective experiences of immigrant Indian nurses in Italy and specifically their professional and social integration. BACKGROUND: To study the worldwide, nursing flux is a health priority in the globalised world. The growth in migration trends among nurses, not only from Philippines or India, has proliferated in recent years. The research on nurses' mobility for Southern European countries is underexplored, and in Italy, the out-migration flows of Indian nurses were never analysed. DESIGN: Qualitative methodological approach. METHODS: Semi-structured interviews (n = 20) were completed with Indian clinical nurses working in Italy for more than one year mainly in private organisations. A purposive sampling technique was used for recruitment. The data were then content-analysed using an inductive method. RESULTS: The findings were categorised into four themes: (1) aspects of professional integration and working experience, (2) intra- and interprofessional relationships and perceptions of the IPASVI Regulatory Nursing Board, (3) initial nursing education and continuous professional development and (4) perceptions of social integration. CONCLUSION: The results show that for Indian nurses in Italy emigration is important to gain opportunities to expand economic and social privileges as well as escape from historical assumptions of stigma associated with nursing work, especially for women. However, these conclusions have to be seen in wider socio-cultural complexities that are at the basis of transnational fluxes (Prescott & Nichter ). RELEVANCE TO CLINICAL PRACTICE: The research offers an insight into the complicated reasons for Indian nurses out-migration to Italy. Without comprehending the interwoven textures of the political and social relations that are continually constructed and re-constructed among different nations, it is difficult to understand nurses out-migration and consequently have a better and safer collaborative teamwork in the host countries

Use of ocean colour remote sensing to monitor sea surface suspended sediments

Ocean colour remote sensing (OCRS) from satellite platforms has revolutionised our ability to monitor the interplay of physical and biogeochemical processes in surface waters of the ocean. Since the launch of SeaWiFS in 1996, a continuous time series of OCRS data has been accumulated from a series of satellite sensors giving near daily global coverage. These sensors measure top of atmosphere (TOA) spectral radiance which is corrected for atmospheric effects (~80% of the measured signal in the blue - Gordon 1978) to give water leaving radiances. From these putrely optical signals, it is possible to derive a wide range of higher level products such as chlorophyll concentration, diffuse attenuation coefficients, photosynthetically available radiation (PAR) and a wide range of inherent optical properties (IOPs) to name but a few. In terms of surface area and primary productivity, the global ocean is heavily dominated by deep, oceanic waters, where the optical properties are driven by phytoplankton, associated dissolved organics and water itself. It is little surprise then that early standard OCRS products were developed for optimal performance over these globally significant regions. Standard chlorophyll algorithms were developed using changes in blue-green reflectance ratios (e.g. O’Reilley et al., 1998) that can be related to the effect of changing concentrations of microscopic scale (1µm-200µm) phytoplankton (Kirk,1983) forming blooms that can stretch for thousands of km. More recently, attention has shifted to economically important coastal regions where, for example, harmful algal blooms have potential to cause significant societal and economic impact. OCRS algorithms have been developed to specifically aid in the monitoring of both toxic species e.g. Karenia brevis in the Gulf of Mexico (Stumpf et al., 2003), and also to monitor for extreme eutrophication events where excessive levels of phytoplankton cause the reduction of oxygen dissolved in the water column (hypoxia) leading to animal mortality (e.g. Mallin et al., 2006). The optically complex nature of coastal waters, more generally, presents a particular problem for OCRS applications in these regions. Shallow shelf seas and other inshore waters are subject to the influence of sediment resuspension and freshwater discharge bringing additional loads of coloured dissolved organic materials (CDOM). This results in multiple, independently varying, optically significant components, each of which influences the water leaving radiance spectrum making interpretation of spectral changes significantly more difficult. Many studies have demonstrated the breakdown in performance of standard algorithms (e.g. Chl, McKee et al. 2007) in optically complex coastal waters. In this paper we will focus on the effect of suspended sediment on optical properties of the water column. Suspended sediment has long been known to influence light penetration (Gordon and McCluney, 1975) which can limit primary production and also contribute to hypoxia (Greig et al., 2005). There is interest in monitoring sediment concentration for coastal erosion applications and various OCRS algorithms have been developed that exploit the relatively strong backscattering properties of sediment. For example, Doxaran et al. (2002) successfully presented a sediment algorithm for the highly turbid Gironde estuary. More recently a radiative transfer approach was used to refine this type of approach to incorporate the potential impact of other materials on the red reflectance values that support sediment algorithms (Neil et al., 2011). This algorithm provides estimates of maximum and minimum sediment load concentrations assuming reasonable potential ranges of Chl and CDOM for coastal waters. The aim of this paper is to determine the extent to which the Neil et al. algorithm, which was developed for Irish Sea waters, can be applied to data collected in the North Sea. The ultimate goal is to assess the potential for using OCRS data to monitor suspended sediment concentrations in coastal waters, with monitoring marine turbine arrays an obvious and potentially important application

Development and characterization of an amorphous solid dispersion of furosemide in the form of a sublingual bioadhesive film to enhance bioavailability

Administered by an oral route, Furosemide (FUR), a diuretic used in several edematous states and hypertension, presents bioavailability problems, reported as a consequence of an erratic gastrointestinal absorption due to various existing polymorphic forms and low and pH-dependent solubility. A mucoadhesive sublingual fast-dissolving FUR based film has been developed and evaluated in order to optimize the bioavailability of FUR by increasing solubility and guaranteeing a good dissolution reproducibility. The Differential Scanning Calorimetry (DSC) analyses confirmed that the film prepared using the solvent casting method entrapped FUR in the amorphous state. As a solid dispersion, FUR increases its solubility up to 28.36 mg/mL. Drug content, thickness, and weight uniformity of film were also evaluated. The measured Young\ue2\u80\u99s Modulus, yield strength, and relative elongation of break percentage (EB%) allowed for the classification of the drug-loaded film as an elastomer. Mucoadhesive strength tests showed that the force to detach film from mucosa grew exponentially with increasing contact time up to 7667 N/m2. FUR was quickly discharged from the film following a trend well fitted with the Weibull kinetic model. When applied on sublingual mucosa, the new formulation produced a massive drug flux in the systemic compartment. Overall, the proposed sublingual film enhances drug solubility and absorption, allowing for the prediction of a rapid onset of action and reproducible bioavailability in its clinical application

Studies of network organization and dynamics of e-beam crosslinked PVPs: From macro to nano

In this work the influence of poly(N-vinylpyrrolidone)(PVP)concentration in water on the organization and dynamics of the corresponding macro-/nanogel networks has been systematically investigated. Irradiation has been performed at the same irradiation dose(within the sterilization dose range)and dose rate. In the selected irradiation conditions, the transition between macroscopic gelation and micro/nanogels formation is observed just below the critical overlap concentration(1 wt%),whereas the net prevalence of intramolecular over intermolecular crosslinking occurs at a lower polymer concentration(below 0.25 wt%). Dynamic\u2013mechanical spectroscopy has been applied as a classical methodology to estimate the network mesh size for macrogels in their swollen state, while 13C NMR spin\u2013lattice relaxation spectroscopy has been applied on both the macrogel and nanogel freeze dried residues to withdraw interesting information of the network spatial organization in the passage of scale from macrotonano

Inherently fluorescent polyaniline nanoparticles in a dynamic landscape

In this paper we report for the first time on the emissive behavior of two polyaniline (PANI) nanoparticle systems produced via oxidative chemical polymerization in the presence of either poly(vinyl alcohol)(PVA) or chitosan as polymeric stabilizers in water. The emission from PANI nanoparticles is irreversibly quenched by an increase of pH of the suspending medium from acid to neutral (chitosan–PANI) or alkaline (PVA–PANI). Conversely, PANI nanorods synthesized in the same conditions of the above, but in presence of poly(N-vinyl pyrrolidone), is not emissive at any pH. The role of the polymeric surfactant as a soft template is key in controlling the morphology and the properties of the obtained PANI dispersions. FTIR, UV–Vis absorption and photoluminescence excitation (PLE) spectra studies suggest that the emissive properties are related to the establishment of strong, non-covalent interactions between nanoscalar PANI particles and the polymeric surfactant at the pH of synthesis. Morphology examination of the three systems, by both dynamic light scattering (DLS) and Transmission Electron Microscopy (TEM), reveal that photoluminescence is associated to the presence of a genuinely 3D nanoscalar morphology, together with an ordered disposition of PANI chains into aligned crystal planes. Concomitant to the irreversible quenching of the emission signal with increasing pH, there is an evolution of the morphology leading to particle coalescence, coarsening and ultimately phase-separation, with consequent modification of PANI–polymeric surfactant interactions, PANI chains supra-molecular organization and optical properties of the PANI nanoparticles dispersion

The Evolution of Professional Nursing Culture in Italy: Metaphors and Paradoxes

We explored the perceptions of Italian nurses regarding their developing culture as a health profession. We sought to understand the ongoing evolution of the nursing profession and the changes that were central to it becoming an intellectual discipline on par with the other health professions in Italy. In 2010, the Regulatory Board of Nursing established a center of excellence to build evidence-based practice, advocate for interdisciplinary health care, and champion health profession reforms for nursing. In this study, focus groups—involving 66 nurse participants from various educational, clinical, and administrative backgrounds—were utilized to better ascertain how the profession has changed. Six themes, three of them metaphors—“vortex,” “leopard spots,” and “deductive jungle”—explain nurses’ experiences of professional change in Italy between 2001 and 2011 and the multiple dimensions that characterize their professional identity and autonomy

Modelling wave-current interactions off the east coast of Scotland

Densely populated coastal areas of the North Sea are particularly vulnerable to severe wave conditions, which overtop or damage sea-defences leading to dangerous flooding. Around the shallow southern North Sea, where the coastal margin is low-lying and population density is high, oceanographic modelling has helped to develop forecasting systems to predict flood risk. However coastal areas of the deeper northern North Sea are also subject to regular storm damage but there has been little or no effort to develop coastal wave models for these waters. Here we present a high spatial resolution model of northeast Scottish coastal waters, simulating waves and the effect of tidal currents on wave propagation, driven by global ocean tides, far-field wave conditions, and local air pressure and wind stress. We show that the wave- current interactions and wave-wave interactions are particularly important for simulating the wave conditions close to the coast at various locations. The model can simulate the extreme conditions experienced when high (spring) tides are combined with sea-level surges and large Atlantic swell. Such a combination of extremes represents a high risk for damaging conditions along the Scottish coast

Water-borne Polymeric Nanoparticles for Glutathione-Mediated Intracellular Delivery of Anticancer Drugs.

A new family of water-borne, biocompatible and carboxyl- functionalized nanogels was developed for glutathione- mediated delivery of anticancer drugs. Poly(N-vinyl- pyrrolidone)-co-acrylic acid nanogels were generated by e- beam irradiation of aqueous solutions of a crosslinkable polymer, using industrial-type linear accelerators and set- ups. Nanogels physico-chemical properties and colloidal stability, in a wide pH range, were investigated. In vitro cell studies proved that the nanogels are fully biocompatible and able to quantitatively bypass cellular membrane. An anticancer drug, doxorubicin (DOX), was linked to the carboxyl groups of NGs through a spacer containing a disulphide cleavable linkage. In vitro release studies showed that glutathione is able to trigger the release of DOX through the reduction of the S-S linkage at a concentration comparable to its levels in the cytosol

Self-reactive human CD4 T cell clones form unusual immunological synapses

Recognition of self–peptide-MHC (pMHC) complexes by CD4 T cells plays an important role in the pathogenesis of many autoimmune diseases. We analyzed formation of immunological synapses (IS) in self-reactive T cell clones from patients with multiple sclerosis and type 1 diabetes. All self-reactive T cells contained a large number of phosphorylated T cell receptor (TCR) microclusters, indicative of active TCR signaling. However, they showed little or no visible pMHC accumulation or transport of TCR–pMHC complexes into a central supramolecular activation cluster (cSMAC). In contrast, influenza-specific T cells accumulated large quantities of pMHC complexes in microclusters and a cSMAC, even when presented with 100-fold lower pMHC densities. The self-reactive T cells also maintained a high degree of motility, again in sharp contrast to virus-specific T cells. 2D affinity measurements of three of these self-reactive T cell clones demonstrated a normal off-rate but a slow on-rate of TCR binding to pMHC. These unusual IS features may facilitate escape from negative selection by self-reactive T cells encountering very small amounts of self-antigen in the thymus. However, these same features may enable acquisition of effector functions by self-reactive T cells encountering large amounts of self-antigen in the target organ of the autoimmune disease