A Transitional Model for the Evaluation of West Nile Virus Transmission in Italy

In August 2008, after 10 years of apparent silence, West Nile virus (WNV) infection re‐emerged in northern Italy, spreading through the territories of three regions. In the following years, new cases occurred in the same area and additional foci of infection were observed in central and southern Italy, involving also Sicily and Sardinia islands. The Italian Ministry of Health ordered to test by RT‐PCR all blood and organ donors from 15th June to 15th November of each year in the infected areas. The period at risk of WNV transmission was defined on the basis of literature data, but a more scientific estimation of the transmission season, under Italian circumstances, needs to be performed. A transitional model previously developed by other Authors was applied and adapted to Italian circumstances, to describe and quantify the WNV transmission cycle between birds and mosquitoes. Culex spp. was considered the main vector, and mosquito parameters were adapted to this genus. Magpies (Pica pica) were considered the main bird host. The model was partially validated through the results of the entomological surveys carried out in central Italy and in Po Valley. The results of the transitional model permitted to calculate the basic reproduction number (R₀) during 2010 for the whole Italian territory at 1 km of spatial resolution, estimating the risk of WNV transmission during the year and creating detailed risk maps for Italy. The mean values of R₀ for the whole Italy varied between 0.4 and 4.8, with values >1 from the end of May to the middle of September. The coastal and flat zones of Italy showed the highest R₀ values. Although partially validated, the model showed a substantial acceptable capacity of defining the period at major risk of WNV transmission in Italy, helping Public health authorities in the application of appropriate and timely control and preventive measures.     

Multiple primary (even in situ) melanomas in a patient pose significant risk to family members

BackgroundWe aimed at assessing familial risk of melanoma by considering a detailed family history of multiple primary (invasive/in situ) melanomas (MPM), stratified by histology and location.MethodsAmong 65,429 melanoma patients diagnosed in 1958–2010 in the Swedish Family-Cancer Database, there were 4248 patients with familial melanoma. A detailed family history of MPM was investigated by number of melanomas in one first-degree relative (FDR) and in ⩾2 FDRs. Familial melanoma risk was assessed by standardised incidence ratios (SIRs) comparing those with family history of melanoma to those without. Combining invasive/in situ melanoma was due to essentially identical familial risks.ResultsFor one affected FDR, familial risk increased from SIR = 2.2 (95% confidence interval (CI) = 2.2–2.3) for single melanoma to 16.3 (9.5–26.1) for ⩾5 melanomas, while for ⩾2 affected FDRs, the risk increased from 5.5 (4.8–6.2) for single melanoma to 23.9 (13.6–38.8) for ⩾2 melanomas. Significantly higher familial risks for superficial spreading melanoma (SSM) [2.5 (2.3–2.6)] than lentigo maligna melanoma (LMM) [1.8 (1.6–2.1)], and for multiple parts [5.3 (3.1–8.4)] and trunk [2.6 (2.5–2.8)] than head/neck [2.0 (1.8–2.2)] were observed. Only at head/neck, significantly higher risk for SSM [2.4 (1.9–3.0)] than LMM [1.6 (1.4–1.8)] was noted.ConclusionWe found, for the first time, that familial risks were similar for two/three melanomas in one FDR or for a single melanoma in ⩾2 FDRs and, higher familial risks for SSM than LMM occurred only at head/neck. This study provides new evidence for genetic counselling in melanoma, suggesting the need for considering not only the number of affected family members but also the diagnosis of MPM (even in situ) in relatives.     

The Rehabilitation of Offenders: Reducing Risk and Promoting Better Lives

This article examines the nature of offender rehabilitation and briefly reviews the effectiveness of correctional interventions in reducing recidivism. It then outlines the two most prominent contemporary theories of offender rehabilitation: the Risk-Need-Responsivity Model and the Good Lives Model (GLM). Our aim is to introduce these two broad rehabilitation frameworks and analyse their practice implications. We conclude that the GLM can offer an alternative view of offender rehabilitation that seeks to help offenders live more fulfilling lives while also reducing risk.     

Responsabilidad en Anestesiología: teoría del daño desproporcionado

An analysis is made of the controversial application of the theory of disproportionate damage in the anaesthetic act, due to the high inherent risk, and regardless of the seriousness and importance of the surgery being performed. The existence of a disproportionate damage, that is, damage not foreseen nor accountable within the framework of the professional performance of the anaesthetist, does not by itself determine the existence of liability on the part of the anaesthetist, but the demand from the professionals themselves for a coherent explanation of the serious disagreement between the initial risk implied by their actions and the final consequence produced.     

胰十二指肠切除术后胰瘘的危险因素及护理对策

目的研究胰十二指肠切除术后出现胰瘘的危险因素及护理对策。方法回顾分析本院普外科收治的70例接受胰十二指肠切除术患者的临床资料,观察胰瘘情况及其治疗情况,并分析其发生原因并制定相应护理对策。结果胰腺质地、糖尿病、高血压均为导致胰瘘的独立危险因素。遵医嘱对本组出现胰瘘患者进行抗生素用药处理,采用抑制胰液分泌的药物控制病情发展,患者在用药1周后引流液逐渐变少,2周后患者均康复出院,患者生存质量评分各项指标较好。结论临床针对胰瘘患者术后制定相应护理干预措施并做好并发症预防工作,并积极分析胰瘘危险因素,患者治疗效果较好且生存质量评分较高。     

Discourses on the Toxic Effects of Internal Chemical Contamination in Catalonia,Spain

Human exposure to and contamination by environmental toxic compounds generates discourses and practices that merit greater attention. In this article, we assess internal chemical contamination and the risk of toxic effects as an experience related to the production of meaning in everyday life. Drawing on the analysis of semantic networks of narratives from semi-structured interviews conducted with 43 informants in Catalonia, Spain, we consider participants’ perceptions of the health risks of toxic compounds, including social discourses on exposure, toxicity, and internal chemical contamination, and on responsibilities, consequences, and proposed strategies for controlling toxic compounds. Informants’ narratives on the relationships between nature and nurture suggest that they no longer perceive rigid boundaries separating the human body from the external environment and its chemical pollutants.