Pain prevalence, severity, assessment and management in hospitalized adult patients: a result of a multicenter cross-sectional study

Introduction. The measurement of pain prevalence among the patients admitted to hospital, estimated that pain remains a common problem for patients. Methods. This is a multi-center cross sectional study carried out in Italian Hospitals, where data was collected in only one day. All patients aged at least 18 years, hospitalized able or unable to communicate, were eligible to be included in the study. Patients with curarization or quadriplegia (any cause) were excluded. Results. Some hospitals and residential structures took part in our research, 26 centers in total. Pain prevalence has been observed in 268 patients (38%) (95% CI = 34%-41%) (range within wards 31-47%). Women are at higher risk than men (RR = 1.59, 95% CI = 1.29-1.95). Pain prevalence was more observed at 10.9 (+1.46) days after surgery. Severe pain has been observed in 148 (21.2%) cases. Pain was managed in 223 (83.2%) cases, and it was predominantly treated with the administration of paracetamol (n=55; 24.7%) within 30 minutes after having ascertained the presence of pain. Conclusions. Pain is reported by about 4 out of 10 adults, with a higher prevalence of cases in women, and its appearance does not depend on the care setting. In order to assess the prevalence of pain carefully, an Italian study that involves all regions and a large number of the centers, may be necessary.

Gait Monitoring and Analysis: A Mathematical Approach

Gait abnormalities are common in the elderly and individuals diagnosed with Parkinson’s, often leading to reduced mobility and increased fall risk. Monitoring and assessing gait patterns in these populations play a crucial role in understanding disease progression, early detection of motor impairments, and developing personalized rehabilitation strategies. In particular, by identifying gait irregularities at an early stage, healthcare professionals can implement timely interventions and personalized therapeutic approaches, potentially delaying the onset of severe motor symptoms and improving overall patient outcomes. In this paper, we studied older adults affected by chronic diseases and/or Parkinson’s disease by monitoring their gait due to wearable devices that can accurately detect a person’s movements. In our study, about 50 people were involved in the trial (20 with Parkinson’s disease and 30 people with chronic diseases) who have worn our device for at least 6 months. During the experimentation, each device collected 25 samples from the accelerometer sensor for each second. By analyzing those data, we propose a metric for the “gait quality” based on the measure of entropy obtained by applying the Fourier transform

Tecnología y comunicación: herramientas para la transparencia en los gobiernos locales

La accesibilidad de los ciudadanos a documentos, información y procedimientos de la gestión del gobierno municipal propia del Gobierno Abierto, se funda en principios y condiciones básicas de transparencia y rendición de cuentas y en la participación y colaboración de los mismos en procesos decisionales. Adicionalmente resulta fundamental la innovación en materia de TICs, la sistematización e informatización de procesos críticos de la gestión organizacional y el desarrollo de aplicaciones que soporten dichos procesos; aspectos todos que han tenido un desarrollo notorio en los últimos años y especialmente en el contexto de la pandemia del Covid-19. El presente trabajo, enmarcado en un Proyecto de Investigación de la Universidad Nacional de Entre Ríos, que pretende desarrollar un sistema de indicadores de responsabilidad social y sustentabilidad para gobiernos locales, tiene por objeto presentar los principales resultados que surgen de un relevamiento efectuado en las Áreas de Sistemas de Municipios del corredor del Río Uruguay, en la provincia de Entre Ríos. Del mismo surgen como principales resultados, la presencia de asimetrías entre los municipios de mayor tamaño, que cuentan con estructuras internas asignadas a las funciones específicas de desarrollo de software, importante nivel de integración, desarrollos internos y a medida de las necesidades, y en general, un mayor control sobre los datos relevados y almacenados, así como de la información suministrada a ciudadanos y demás grupos de interés, lo que impacta de forma directa en los niveles de transparencia.Track «Gobierno Digital y Ciudades Inteligentes»Red de Universidades con Carreras en Informátic

Psychometric testing of the caregiver contribution to self-care of coronary heart disease inventory

Background: Caregivers are important contributors to the self-care of patients with coronary heart disease (CHD). Aims: The aims of this study are to describe the development and psychometric properties of the caregiver contribution to self-care of coronary heart disease inventory (CC-SC-CHDI). Methods: The CC-SC-CHDI was developed from the patient version of the scale, the Self-care of Coronary Heart Disease Inventory (SC-CHDI) and translated into Italian using forward and backward translation. Baseline data from the HEARTS-IN-DYADS study were used. Confirmatory factor analysis (CFA) was conducted to assess factorial validity; Cronbach's alpha and the model-based internal consistency index were used to test internal consistency reliability, and Pearson's correlation coefficient was used to test convergent validity, by investigating the association between the CC-SC-CHDI and the SC-CHDI scores. Results: We included 131 caregivers (mean age 55 years, 81.2% females, 74% married) of patients affected by CHD (mean age 66 years, 80.2% males, 74% married). The CFA confirmed two factors in the caregiver contribution to self-care maintenance scale ("consulting behaviors" and "autonomous behaviors"), one factor for the CC to self-care monitoring scale, and two factors in the CC to self-care management scale ("consulting behaviors and problem-solving behaviors"). Reliability estimates were adequate for each scale (Cronbach's alpha and model-based internal consistency indexes ranging from 0.73 to 0.90). Significant and positive correlations were observed between CC-SC-CHDI and SC-CHDI scales. Conclusion: The CC-SC-CHDI has satisfactory validity and reliability and can be used confidently in clinical settings and research to assess caregiver contributions to CHD self-care

Bed rest duration and complications after transfemoral cardiac catheterization: a network meta-analysis

AIM: To assess the effects of bed rest duration on short-term complications following transfemoral catheterization. METHODS & RESULTS: A systematic search was carried out in MEDLINE, Embase, CINAHL, Cochrane Database of Systematic Reviews, Scopus, SciELO, and in five registries of grey literature. Randomized controlled trials and quasi-experimental studies comparing different duration of bed rest after transfemoral catheterization were included. Primary outcomes were hematoma and bleeding near the access site. Secondary outcomes were arteriovenous fistula, pseudoaneurysm, back pain, general patient discomfort and urinary discomfort. Study findings were summarized using a network meta-analysis (NMA).Twenty-eight studies and 9217 participants were included (mean age 60.4 years). In NMA, bed rest duration was not consistently associated with either primary outcome, and this was confirmed in sensitivity analyses. There was no evidence of associations with secondary outcomes, except for two effects related to back pain. A bed rest duration of 2-2.9 hours was associated with lower risk of back pain (RR 0.33, 95%CI 0.17-0.62), and a duration over 12 hours with greater risk of back pain (RR 1.94, 95%CI 1.16-3.24), when compared to the 4-5.9 hours interval. Post-hoc analysis revealed an increased risk of back pain per hour of bed rest (RR 1.08, 95%CI 1.04-1.11). CONCLUSIONS: A short bed rest was not associated with complications in patients undergoing transfemoral catheterization; the greater the duration of bed rest, the more likely patients were to experience back pain. Ambulation as early as 2 hours after transfemoral catheterization can be safely implemented. REGISTRATION: URL: https://www.crd.york.ac.uk/prospero. Identifier: PROSPERO CRD42014014222

Bed rest duration and complications after transfemoral cardiac catheterization: a network meta-analysis

Aims To assess the effects of bed rest duration on short-term complications following transfemoral catheterization. Methods and results A systematic search was carried out in MEDLINE, Embase, CINAHL, Cochrane Database of Systematic Reviews, Scopus, SciELO and in five registries of grey literature. Randomized controlled trials and quasi-experimental studies comparing different durations of bed rest after transfemoral catheterization were included. Primary outcomes were haematoma and bleeding near the access site. Secondary outcomes were arteriovenous fistula, pseudoaneurysm, back pain, general patient discomfort and urinary discomfort. Study findings were summarized using a network meta-analysis (NMA). Twenty-eight studies and 9217 participants were included (mean age 60.4 years). In NMA, bed rest duration was not consistently associated with either primary outcome, and this was confirmed in sensitivity analyses. There was no evidence of associations with secondary outcomes, except for two effects related to back pain. A bed rest duration of 2-2.9 h was associated with lower risk of back pain [risk ratio (RR) 0.33, 95% confidence interval (CI) 0.17-0.62] and a duration over 12 h with greater risk of back pain (RR 1.94, 95% CI 1.16-3.24), when compared with the 4-5.9 h interval. Post hoc analysis revealed an increased risk of back pain per hour of bed rest (RR 1.08, 95% CI 1.04-1.11). Conclusion A short bed rest was not associated with complications in patients undergoing transfemoral catheterization; the greater the duration of bed rest, the more likely the patients were to experience back pain. Ambulation as early as 2 h after transfemoral catheterization can be safely implemented. Registration PROSPERO: CRD42014014222

Bed rest for preventing complications after transfemoral cardiac catheterisation: a protocol of systematic review and network meta-analysis.

BACKGROUND: Transfemoral cardiac catheterisation is an invasive medical procedure used for therapeutic or diagnostic purposes. Postoperative bed rest can prevent a number of complications such as bleeding and haematoma formation and can result in side effects such as back pain and urinary discomfort. Currently, there is no consensus regarding the optimal length of bed rest. Our objective is to assess the effects of post-catheterisation length of bed rest on bleeding and haematoma, other vascular complications, patient symptoms and patient discomfort, among patients who underwent transfemoral cardiac catheterisation. METHODS: We wrote this protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. We defined the search query by using the PICO framework (Population: Patients undergoing cardiac catheterisation; INTERVENTION: early mobilisation; Comparison: late mobilisation; OUTCOMES: early and late complications). We will search six biomedical databases and five online registries to obtain both published and unpublished studies. We will include randomised controlled trials and quasi-randomised controlled trials, and their quality will be independently appraised with the Cochrane Effective Practice and Organisation of Care criteria for quality assessment. We will carry out a pairwise meta-analysis and network meta-analysis to estimate the overall intervention effects from both direct and indirect comparisons. DISCUSSION: This review may have considerable implications for practice and help to achieve an effective and efficient management of patients who underwent cardiac catheterisation. This review will be grounded in an expanded search of 11 resources and will employ innovative statistical methods such as network meta-analysis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42014014222

Proposta de elemento de integração para a interface entre alvenaria estrutural e esquadria

A utilização de sistemas modulares na indústria da construção tem crescido de forma acentuada nos últimos anos no Brasil, sendo que, dentre estes, se destaca o sistema construtivo de alvenaria estrutural. Entretanto, diversos estudos apontam uma alta incidência de manifestações patológicas relacionadas a este sistema. A interface entre alvenaria e esquadria é um dos locais de maior incidência de problemas, além de representar um gargalo construtivo, pela necessidade de realização de inúmeras atividades que dependentes da mesma. O presente artigo apresenta o processo de desenvolvimento de uma nova solução para este problema, denominada elemento de integração, incluindo sua definição geométrica, funcional e conceitual, bem como a produção de protótipos virtuais e físicos (com diferentes materiais). Ao longo do desenvolvimento de diferentes modelos, foram realizadas avaliações pela equipe de projeto, a partir das quais foram introduzidas melhorias. Ao todo, foram produzidos 4 modelos virtuais, 3 modelos físicos na escala 1:1, e uma parede experimental. Os principais resultados apontam para a viabilidade e adequação da proposta ao sistema construtivo, bem como identificam o possível aumento de construtibilidade do sistema como um todo a partir da aplicação do elemento desenvolvido