11 research outputs found
A pilot study on the effects of a team building process on the perception of work environment in an integrative hospital for neurological rehabilitation
<p>Abstract</p> <p>Background</p> <p>Neurological rehabilitation is one of the most care-intensive challenges in the health care system requiring specialist therapeutic and nursing knowledge. In this descriptive pilot study, we investigated the effects of a team building process on perceived work environment, self-ascribed professional competence, life satisfaction, and client satisfaction in an anthroposophic specialized hospital for neurological rehabilitation. The team-building process consisted of didactic instruction and training in problem-solving, teambuilding and constructive conflict resolution.</p> <p>Methods</p> <p>Seventy seven staff members and 44 patients' relatives were asked to complete a survey that included the Work Environment Scale (WES-10), a Life Satisfaction Scale (BMLSS), the Conviction of Therapeutic Competency (CTC) scale and the Client Satisfaction Questionnaire (CSQ-8). To evaluate the outcome of the team building process, we analyzed changes over time in the WES-10 subscales. Additionally the interrelationship between the WES-10 subscales with other subscales and with sociodemographic parameters like age, gender was calculated by means of a bivariate correlation analysis.</p> <p>Results</p> <p>The team building process had a significant positive effect on perceived work environment in only one area. There was a significant improvement in the ward staffs' perception of their ability to constructively resolve conflicts 3 years after inception of the team building process than there was before inception. However, even in a unit that utilized holistic treatment and nursing in the care of severely disable patients, such care necessitating a very heavy workload, the measurements on the Self Realization, Life Satisfaction and Conviction of Therapeutic Competency scales remained high and unchanged over the three year time period of the study.</p> <p>Conclusions</p> <p>Strategic interventions might be an option to improve interpersonal relationships and finally quality of patient care.</p
Low inâhospital mortality rate in patients with COVIDâ19 receiving thromboprophylaxis: data from the multicentre observational STARTâCOVID Register
Abstract
COVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established. We conducted a multicentre,
Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thromboprophylaxis and its role on patient outcome were, also, described. 1091 patients hospitalized were included in
the START-COVID-19 Register. During hospital stay, 769 (70.7%) patients were treated with antithrombotic drugs: low molecular weight heparin (the great majority enoxaparin), fondaparinux, or unfractioned heparin. These patients were more frequently affected by comorbidities, such as hypertension, atrial fibrillation, previous thromboembolism, neurological disease,and cancer with respect to patients who did not receive thromboprophylaxis. During hospital stay, 1.2% patients had a major bleeding event. All patients were treated with antithrombotic drugs; 5.4%, had venous thromboembolism [30.5% deep vein thrombosis (DVT), 66.1% pulmonary embolism (PE), and 3.4% patients had DVT + PE]. In our cohort the mortality rate
was 18.3%. Heparin use was independently associated with survival in patients aged â„ 59 years at multivariable analysis. We confirmed the high mortality rate of COVID-19 in hospitalized patients in ordinary wards. Treatment with antithrombotic drugs is significantly associated with a reduction of mortality rates especially in patients older than 59 years
L'Italia come modello per l'Europa e per il mondo nelle politiche sanitarie per il trattamento dell'epatite cronica da HCV
The World Health Organization foresees the
elimination of HCV infection by 2030. In light of this and the curre
nt, nearly worldwide, restriction in direct-acting agents
(DAA) accessibility due to their high price, we aimed to evaluate
the cost-effectiveness of two alternative DAA treatment
policies: Policy 1 (universal): treat all patients, regardless of the fibrosis stage; Policy 2 (prioritized): treat only priori
tized
patients and delay treatment of the
remaining patients until reaching stage F3. T
he model was based on patientâs data
from the PITER cohort. We demonstrated that extending HC
V treatment of patients in any fibrosis stage improves health
outcomes and is cost-effective
LâattivitĂ dei Centri Antifumo italiani tra problematiche e aree da potenziare: i risultati di unâindagine svolta attraverso un questionario on-line
Introduzione. In Italia sono 295 i Servizi per la cessazione dal
fumo di tabacco (Centri Antifumo - CA) afferenti al Servizio Sanitario
Nazionale (SSN) censiti nel 2011 dallâOsservatorio Fumo,
Alcol e Droga (OssFAD) dellâIstituto Superiore di SanitĂ . La presente
indagine, condotta dallâOssFAD in collaborazione con i CA,
Ăš stata volta a rilevare alcune delle problematiche con le quali il
personale dei CA si confronta per portare avanti la propria attivitĂ
e le iniziative ritenute utili per migliorarla.
Materiali e metodi. Lâindagine Ăš stata condotta dal 7 al 21
maggio 2012, mediante un questionario compilabile on-line
composto da 5 brevi sezioni di domande con un totale di 38
items da completare. Il link al questionario on-line Ăš stato inviato
per e-mail a 322 indirizzi dei CA censiti nel 2011 dallâOssFAD. I
dati raccolti sono stati elaborati statisticamente con il programma
SPSS 20.
Risultati. Allâindagine hanno risposto 146 operatori dei CA
(45,3%). Sebbene ci siano aspetti ormai consolidati dellâattivitĂ
dei CA, sono ancora molte le criticitĂ che gli operatori riscontrano
nella loro attivitĂ . Le principali problematiche che influiscono
in modo fondamentale/rilevante per la buona attivitĂ
del centro sono le âScarse o nulle risorse economicheâ per il
60,7% del personale, âla mancanza di personale dedicatoâ per
il 52,4% del personale; il âriconoscimento/mandato istituzionale
del CAâ per il 40,9% del personale. Tra le azioni ritenute
piĂč efficaci per facilitare lâaccesso ai CA sono risultate la sensibilizzazione
del personale sanitario (91%), in particolare dei medici
di famiglia e lâinserimento delle prestazioni antitabagiche
nei LEA (76,8%).
Conclusioni. Ă auspicabile che lâattivitĂ dei CA riceva una maggiore
attenzione, attraverso la dotazione di strutture, personale
e finanziamenti adeguati a svolgere un importante ruolo nella
tutela e promozione della salute
Modulation of immune responses by targeting CD169/Siglec-1 with the glycan ligand
A fundamental role in the plant-bacterium interaction for
Gram-negative phytopathogenic bacteria is played by membrane
constituents, such as proteins, lipopoly- or lipooligosaccharides
(LPS, LOS) and Capsule Polysaccharides (CPS).
In the frame of the understanding the molecular basis of plant bacterium interaction, the Gram-negative bacterium Agrobacterium vitis was selected in this study. It is a phytopathogenic member of the Rhizobiaceae family and it induces the crown gall disease selectively on grapevines (Vitis vinifera).
A. vitis wild type strain F2/5, and its mutant in the quorum
sensing gene ÎaviR, were studied. The wild type produces biosurfactants; it is considered a model to study surface motility, and it causes necrosis on grapevine roots and HR (Hypersensitive
Response) on tobacco. Conversely, the mutant does not show any
surface motility and does not produce any surfactant material;
additionally, it induces neither necrosis on grape, nor HR on
tobacco. Therefore, the two strains were analyzed to shed some
light on the QS regulation of LOS structure and the consequent
variation, if any, on HR response. LOS from both strains were isolated and characterized: the two LOS structures maintained several common features and differed for few others.
With regards to the common patterns, firstly: the Lipid A region
was not phosphorylated at C4 of the non reducing glucosamine
but glycosylated by an uronic acid (GalA) unit, secondly: a third
Kdo and the rare Dha (3-deoxy-lyxo-2-heptulosaric acid) moiety
was present.
Importantly, the third Kdo and the Dha residues were substituted
by rhamnose in a not stoichiometric fashion, giving four different
oligosaccharide species.
The proportions among these four species, is the key difference
between the LOSs from both the two bacteria.
LOS from both strains and Lipid A from wild type A. vitis are
now examined for their HR potential in tobacco leaves and grapevine roots