Criteria for standardising counselling for HIV testing

In the present work, we outline basic health counselling skills, specifically, those for performing pre-test and post-test counselling for HIV infection. The ultimate goal is to propose that counselling be performed in facilities that carry out screening for anti-HIV antibodies, following standardised (and thus replicable) criteria, with consistent focus on the quality of the relationship between the healthcare professional and the individual undergoing testing and on the individual's specific needs

The professional skills of the nurse involved in the care of individuals with sexually transmitted infections

INTRODUCTION: Sexually Transmitted Infections (STIs) represent a relevant public health issue that requires the combined contribution of different health care professionals in order to put in place proper prevention, diagnosis and treatment activities  METHODS: The Integrated health care model (PIC) is here applied to STIs. Designed as a territorial network of services including a multidisciplinary team of health care workers, this model works across a number of settings and levels of care. The specific contribution of the nurse with an adequate technical-scientific and relational communication background in STI care provision is analyzed.  RESULTS: Nurses and other Health Care Workers involved in the PIC for STIs are able to respond in a tailored manner to the various health needs of the person. The technical-scientific and relational communication competencies ensure the delivery of quality services. Moreover, nursing care should be STIs person-centred and used for to improve empowerment and healthy behaviors. Appropriate nursing staff education and training aimed at integrating technical-scientific knowledge with relational communication skills on STIs is highly desiderable.  CONCLUSIONS: Nurses area a crucial component in the PIC for STIs, because they are engaged in the care of a complex, delicate and intimate component of the individual. Therefore, to improve service performance, an improvement and extension of nurses duties in STI centers would be highly desirable. Standardized care protocols established by the local Health Department could be used as direction as well as an updating of the current Italian legislation which does not allow to adapt nursing competencies to the real care requirements.  KEYWORDS: sexually transmitted infections, Italy, nurses, integrated care, training, health communication.INTRODUZIONE: Le Infezioni Sessualmente Trasmesse (IST) rappresentano a livello nazionale un importante problema di sanità pubblica che richiede interventi di prevenzione, diagnosi e cura condotti attraverso la collaborazione integrata di professionisti sanitari differenti.  METODI: È stato utilizzato il modello di Percorso Integrato di Cura (PIC) applicandolo alle IST, inteso come rete territoriale che prevede il coordinamento tra le diverse strutture sanitarie e tra i vari operatori sanitari coinvolti in questa specifica area. In tale ambito è stato analizzato il possibile contributo che il professionista infermiere, con un bagaglio tecnico-scientifico e comunicativo-relazionale adeguato, può fornire alla persona direttamente o indirettamente coinvolta in una IST.  RISULTATI: La conduzione di un intervento infermieristico professionale all’interno del PIC per le IST, ovviamente integrato con quello di altre figure professionali, intende rispondere in modo personalizzato ai diversi bisogni di salute espressi dalla persona. Inoltre, mira a promuovere nella persona con IST l’attivazione di processi di empowerment fondamentali per la messa in atto di stili comportamentali adeguati. Emerge, pertanto, l’esigenza di proporre al personale infermieristico un percorso di formazione/aggiornamento finalizzato all’integrazione delle conoscenze tecnico-scientifiche con quelle comunicativo-relazionali in tema di IST.  CONCLUSIONI: Il ruolo dell’infermiere costituisce un elemento cruciale all’interno di un PIC per le IST in quanto impegnato in un’area complessa e delicata che tocca la sfera più intima della persona coinvolgendola nella sua globalità. Appare, pertanto, fortemente auspicabile un ampliamento delle competenze dell’infermiere attraverso, prima, una elaborazione di protocolli aziendali standardizzati stabiliti dalla Direzione Sanitaria in cui opera il professionista infermiere, e successivamente un superamento della normativa vigente che ad oggi non consente di adeguare le competenze infermieristiche alle reali esigenze assistenziali.  PAROLE CHIAVE: infezioni sessualmente trasmesse, Italia, infermiere, percorso di cura integrato, formazione, epidemiologia, comunicazione&nbsp

Communication and basic health counselling skills to tackle vaccine hesitancy

Introduction. The Italian law 119/2017 mandates ten childhood vaccinations to allow population aged 0-16 attend educational places and state school. This law enforcement is due to low coverage rates for some vaccine-preventable diseases and a complex phenomenon as known as vaccine hesitancy.Methods. Within a broad e-learning course programme promoted by the Istituto Superiore di Sanità to public health professionals, a specific training module was developed on communication and basic health counselling skills which represent relevant resources to let healthcare workers effectively address vaccine hesitancy in the population.Results. We indicated recommended communication approaches and basic health counselling skills to be applied by public health professionals according to the specific target population with vaccine deficit, that means people not at all or partially reached by vaccinations.Discussion and conclusions. Public health professionals are called to know, acquire, use, and adapt basic health counselling skills to effectively address vaccine hesitancy diversely affecting different groups of population

Bone Marrow Clonogenic Capability, Cytokine Production, and Thymic Output in Patients with Common Variable Immunodeficiency

AbstractIn patients with primary Ab deficiencies, hematological and immunological abnormalities are frequently observed. A regenerative failure of hemopoietic stem/progenitor cells has been hypothesized. We evaluated in the bone marrow (BM) of 11 patients with common variable immunodeficiency, the phenotype of BM progenitors and their in vitro growth by colony-forming cell (CFC) and long-term culture (LTC) assays. A significant decrease in erythroid and mixed CFC and, to a greater extent, in primitive LTC-CFC progenitors was observed in patients compared with healthy controls. The frequency of BM pre-B and pro-B cells correlated directly with the absolute number of CD19+ lymphocytes. BM cells cultured in vitro produced spontaneously lower amounts of IL-2 and elevated levels of TNF-α compared with controls, indicating a skewing toward a proapoptotic cytokine pattern. In addition, stromal cells generated after BM LTC secreted less IL-7 and displayed by immunohistochemistry an altered phenotype. These findings were associated with a significant decrease in naive Th cells coexpressing CD31 in the peripheral blood. These results indicate an impaired growth and differentiation capacity of progenitor cells in patients with common variable immunodeficiency

Active reflectors for interferometric SAR deformation measurement

This paper is focused on the design, implementation and testing of an active reflector, to be used to support deformation monitoring studies based on Synthetic Aperture Radar interferometry. The device is designed to work in C-band with Sentinel-1 data, operating at 5.405 GHz ± 50 MHz. A brief description of the active reflector is provided. It consists of two antennas and an amplifying section. The active reflector has been tested in different experiments. In this paper, we describe the experiment carried out in the Parc Mediterrani de la Tecnologia (Castelldefels, Barcelona). The result shows a strong correlation with temperature. A calibration test was carried out to experimentally derive a calibration curve to correct the effect of temperature on phase stability.This work is part of a project that has received funding from the European GNSS Agency under the European Union’s Horizon 2020 research and innovation programme, with grant agreement No 776335, project GIMS, “Geodetic Integrated Monitoring System”. This work has been partially funded by AGAUR, Generalitat de Catalunya, through the Consolidated Research Group RSE, “Remote Sensing” (Ref: 2017-SGR-00729)Postprint (published version

HIV Infection among Illegal Migrants, Italy, 2004–2007

To determine HIV prevalence and place of exposure for illegal migrants in Italy, we tested 3,003 illegal adult migrants for HIV; 29 (0.97%) were HIV positive. Antibody avidity index results (indicators of time of infection) were available for 27 of those persons and showed that 6 (22.2%) presumably acquired their infection after migration

Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group

Benign thyroid nodules are a common clinical occurrence and usually do not require treatment unless symptomatic. During the last years, ultrasound-guided minimally invasive treatments (MIT) gained an increasing role in the management of nodules causing local symptoms. In February 2018, the Italian MIT Thyroid Group was founded to create a permanent cooperation between Italian and international physicians dedicated to clinical research and assistance on MIT for thyroid nodules. The group drafted this list of statements based on literature review and consensus opinion of interdisciplinary experts to facilitate the diffusion and the appropriate use of MIT of thyroid nodules in clinical practice. (#1) Predominantly cystic/cystic symptomatic nodules should first undergo US-guided aspiration; ethanol injection should be performed if relapsing (level of evidence [LoE]: ethanol is superior to simple aspiration = 2); (#2) In symptomatic cystic nodules, thermal ablation is an option when symptoms persist after ethanol ablation (LoE = 4); (#3) Double cytological benignity confirmation is needed before thermal ablation (LoE = 2); (#4) Single cytological sample is adequate in ultrasound low risk (EU-TIRADS 643) and in autonomously functioning nodules (LoE = 2); (#5) Thermal ablation may be proposed as first-line treatment for solid, symptomatic, nonfunctioning, benign nodules (LoE = 2); (#6) Thermal ablation may be used for dominant lesions in nonfunctioning multinodular goiter in patients refusing/not eligible for surgery (LoE = 5); (#7) Clinical and ultrasound follow-up is appropriate after thermal ablation (LoE = 2); (#8) Nodule re-treatment can be considered when symptoms relapse or partially resolve (LoE = 2); (#9) In case of nodule regrowth, a new cytological assessment is suggested before second ablation (LoE = 5); (#10) Thermal ablation is an option for autonomously functioning nodules in patients refusing/not eligible for radioiodine or surgery (LoE = 2); (#11) Small autonomously functioning nodules can be treated with thermal ablation when thyroid tissue sparing is a priority and 6580% nodule volume ablation is expected (LoE = 3)