Is the natural feed the better nutritional therapy in patients with severe acquired brain injury? A retrospective study

SUMMARY: Background: This retrospective study aimed to assess whether the use of natural foods, also in combination with enteral nutrition, improves rehabilitative recovery in patients severe acquired brain injuries. Methods: 40 severe acquired brain injuries patients (75% males, aged 50.2 ± 16.6) were selected. The study population was divided into three groups based on the type of nutrition administered (enteral, oral, and mixed). Mini Nutritional Assessment and Level of Cognitive Functioning scales were used to assess changes from admission to discharge in each group. Multiple logistic regression model was performed to assess the association between the feeding typology and nutritional recovery. Results: At admission, about 97.5% of patients were malnourished. We found significant score changes from baseline to follow-up for both test used and in each subgroup, except for the subgroup that includes patients fed with enteral nutrition. There were significant differences in biochemical indicators, including levels of albumin (p < 0.01) and protein (p < 0.001), compared to baseline and follow-up. Oral nutrition resulted to be a significant predictor for nutritional improvement. Conclusions: Nutrition therapy within a multi-disciplinary team may improve both the hospital care and the recovery in severe acquired brain injuries population. Notably, our findings suggest that natural nutrition is superior to enteral nutrition in improving nutritional outcomes, which should be confirmed by further studies

Assessment of insight in hospitalized neurological patient: Cognitive profile and mood disorder

Purpose: Many studies have evaluated the characteristics of insight, especially in psychiatric patient populations. However, this construct has been poorly examined within neurological disorders. We explored the relationship between altered insight, mood disorders and neurocognitive functioning in a sample of patients admitted to a neurological rehabilitation unit. Method: Each patient, at the time of hospitalization (T0), underwent an evaluation of the overall cognitive profile, of the frontal functions, and the compilation of scales aimed at investigating the 4 domains under examination of insight and anxiety-depressive symptomatology. After 3&nbsp;months (T1), at the end of the rehabilitative and supportive treatment, the patients underwent the same evaluation performed at T0. Results: Our results showed significant differences between T0 and T1 in the variables examined related to insight. In particular, there was a correlation between the global cognitive profile, including executive functions, and all insight domains. This confirms how the degree of cognitive deficit, especially of executive type, affects all levels of awareness of the individual. We have also found correlations between mood disorders and insight. In particular, our results show that depression versus anxiety plays a fundamental role in a person's awareness. Conclusions: The study of insight is fundamental not only for the relapses it could have on the patient, but also on those to health care professionals. In fact, having an adequate insight could lead to a greater motivation of the patient to be more complimentary to pharmacological and rehabilitative therapies, also favoring social reintegration

How COVID-19 Has Affected Caregivers’ Burden of Patients with Dementia: An Exploratory Study Focusing on Coping Strategies and Quality of Life during the Lockdown

COVID-19 has caused a public and international health emergency, leading to isolation and social distancing. These restrictions have had a significant impact on the caregivers of people with dementia, increasing the burden of patient management. The purpose of this study was to investigate the stress perceived by caregivers of patients with Alzheimer’s disease (AD) during the pandemic. We used a cross-sectional survey design to evaluate the caregivers’ psychological responses and coping strategies. Eighty-four caregivers of patients with a diagnosis of AD were involved in this study by completing an online questionnaire. They presented a high perception of stress (the Perceived Stress Scale mean ± DS: 33.5 ± 4.5), and their high burden in caring was mainly related to physical difficulties (Caregiver Burden Inventory–Physical Burden mean ± DS: 15.0 ± 2.1) and perception of loss of time (Caregiver Burden Inventory–Time-dependence Burden mean ± DS: 16.5 ± 1.4). Moreover, caregivers perceived their quality of life as very low (Short Form-12 Health Survey Physical mean ± DS: 13.5 ± 2.7; Short Form-12 Health Survey Mental Health mean ± DS: 16.4 ± 4.2). Finally, we found that participants mostly used dysfunctional coping strategies, such as avoidance strategies (Coping Orientation to Problem Experiences–Avoidance Strategies mean ± DS: 39.5 ± 7.1), but these strategies did not affect the stress level of caregivers. Given that caregivers present a high burden and stress, innovative tools could be a valuable solution to investigate and support their emotional and behavioral status during difficult periods, such as the COVID-19 pandemic

Roadmap to the management of marine invasive alien species in Europe: a prioritization exercise in a Mediterranean country

In 2014 the Regulation 1143/14 on invasive alien species (IAS) was issued by the European Community. It provides for important restrictions (as importing and selling) and a set of measures (early detection, rapid eradication or control) that EU member states are required to take for the species included on a list of IAS of Union Concern. The inclusion of a species in this list is based on the results of a risk-assessment procedure. The list, adopted in 2016 and updated in August 2017 contains at present 49 IAS, none of which marine (except from the brackish water crab Eriocheir sinensis). Member states can also adopt a list of “species of national concern” and apply the same measures provided for the species of Union concern. In Italy the scientific community is working on a prioritization exercise to develop a list of IAS of national concern, that may eventually include marine IAS. This list will be composed by both IAS already present and potential new IAS, from a horizon scanning exercise. Their principal pathways have been discussed in relation to the effectiveness of prevention measures. Italy is a major “first hub” for marine introductions in the Mediterranean Sea, with over 200 multicellular marine alien species reported so far. With its central position in the Mediterranean Sea, it shares several species with the Western European countries, carried by ships or with shellfish stocks, as well as a number of Indo-Pacific species with the Eastern Mediterranean countries, entered through the Suez Canal. Therefore, the roadmap that Italy is currently tracing towards the possible inclusion of marine species in the list of IAS to be managed and controlled, is also relevant for other European and Mediterranean countries. This presentation will show how the process has been organized and conducted, and the preliminary outcomes

Roadmap to the management of marine invasive alien species in Europe: a prioritization exercise in a Mediterranean country

In 2014 the Regulation 1143/14 on invasive alien species (IAS) was issued by the European Community. It provides for important restrictions (as importing and selling) and a set of measures (early detection, rapid eradication or control) that EU member states are required to take for the species included on a list of IAS of Union Concern. The inclusion of a species in this list is based on the results of a risk-assessment procedure. The list, adopted in 2016 and updated in August 2017 contains at present 49 IAS, none of which marine (except from the brackish water crab Eriocheir sinensis). Member states can also adopt a list of “species of national concern” and apply the same measures provided for the species of Union concern. In Italy the scientific community is working on a prioritization exercise to develop a list of IAS of national concern, that may eventually include marine IAS. This list will be composed by both IAS already present and potential new IAS, from a horizon scanning exercise. Their principal pathways have been discussed in relation to the effectiveness of prevention measures. Italy is a major “first hub” for marine introductions in the Mediterranean Sea, with over 200 multicellular marine alien species reported so far. With its central position in the Mediterranean Sea, it shares several species with the Western European countries, carried by ships or with shellfish stocks, as well as a number of Indo-Pacific species with the Eastern Mediterranean countries, entered through the Suez Canal. Therefore, the roadmap that Italy is currently tracing towards the possible inclusion of marine species in the list of IAS to be managed and controlled, is also relevant for other European and Mediterranean countries. This presentation will show how the process has been organized and conducted, and the preliminary outcomes