Knowledge and attitudes towards smoking cessation counselling: an Italian cross-sectional survey on tertiary care nursing staff

Background: One of the most effective smoking cessation strategies involves care and advice from nurses due to their role in the front line of treatment. Lack of education on smoking cessation counselling may be detrimental, and adequate smoking cessation training during healthcare studies is needed. Objectives: The study aimed to examine nurses’ attitudes, belief, and knowledge of smoking cessation counselling; knowledge of the health risks associated with smoking was also assessed. Design: A cross-sectional survey on 77 nurses from the nursing staff of Cardiology, Cardiac Intensive Care and Surgical Oncology Units of two tertiary hospitals. Methods: Cronbach’s alpha was calculated to assess the questionnaire’s internal consistency, and three composite indicators were computed to assess the three dimensions of the questionnaire (knowledge, attitude, belief). Furthermore, a stepwise linear regression model was used to predict the attitude to be engaged in smoking cessation counselling, related to demographic and behavioural variables, as well as knowledge and belief indicators. The analysis was stratified by Unit. Results: Nurses from three Units had a significantly different attitude score (2.55 ± 0.93 for Cardiology, 2.49 ± 0.72 for Cardiac Intensive Care and 2.09 ± 0.59 for Surgical Oncology Unit) (P-value = 0.0493). Analogously, knowledge of smoking cessation counselling was reported to be higher for Cardiac Intensive Care Unit nurses (3.19 ± 0.70) compared to Surgical Oncology nurses (2.73 ± 0.74) (P-value = 0.021). At the multivariable analysis, attitude towards smoking cessation counselling was significantly related to the nurse’s belief about counselling, for Cardiology staff (coeff = 0.74, 95% CI [0.32–1.16], P-value = 0.002) and for Surgical Oncology staff (coeff = 0.37, 95% CI [0.01–0.72], P-value = 0.042). Conclusions: Incorporation of smoking cessation interventions in nurses’ and nursing managers’ education could improve the nursing staff’s attitude, belief, and knowledge regarding smoking cessation counselling, which would lead to the inclusion of tobacco prevention and cessation as an integral part of patient care

Reticulocyte Hemoglobin Content Helps Avoid Iron Overload in Hemodialysis Patients: A Retrospective Observational Study

Anemia in patients suffering from end-stage renal failure is currently treated with Erythropoiesis-Stimulating Agents (ESA). This treatment needs sufficient iron supplementation to avoid an inadequate dosage of ESA. Nowadays modern analytical instruments allow to accurately calculate the content of Hemoglobin (Hb) in reticulocytes (CHr), that can be used as a guide for prescribing patients with the appropriate amount of iron

Association of immune-related adverse events with the outcomes of immune checkpoint inhibitors in patients with dMMR/MSI-H metastatic colorectal cancer

Background: Immune checkpoint inhibitors (ICIs) show a tremendous activity in microsatellite instability-high (MSI-H) metastatic colorectal cancer (mCRC), but a consistent fraction of patients does not respond. Prognostic/predictive markers are needed. Despite previous investigations in other tumor types, immune-related adverse events (irAEs) have not been well evaluated in patients with MSI-H cancers treated with ICIs. Methods: We conducted an international cohort study at tertiary cancer centers collecting clinic-pathological features from 331 patients with MSI-H mCRC treated with ICIs. Of note, the irAEs were summarized using a 'burden score' constructed in a way that the same score value could be obtained by cumulating many low-grade irAEs or few high-grade irAEs; as a result, the lower the burden the better. Clearly, the irAE burden is not a baseline information, thus it was modeled as a time-dependent variable in univariable and multivariable Cox models. Results: Among 331 patients, irAEs were reported in 144 (43.5%) patients. After a median follow-up time of 29.7 months, patients with higher burden of skin, endocrine and musculoskeletal irAEs (the latter two's effect was confirmed at multivariable analysis) had longer overall survival (OS), as opposed to gastrointestinal, pneumonitis, neurological, liver, renal and other irAEs, which showed an harmful effect. Similar results were observed for progression-free survival (PFS). Based on the results retrieved from organ-specific irAEs, 'aggregated' burden scores were developed to distinguish 'protective' (endocrine and musculoskeletal) and 'harmful' (gastrointestinal, pneumonitis, neurological, hepatic) irAEs showing prognostic effects on OS and PFS. Conclusions: Our results demonstrate that not all irAEs could exert a protective effect on oncologic outcome. An easy-to-use model for ICIs toxicity (burden score of protective and harmful irAEs) may be used as surrogate marker of response

Pre-treatment risk factors to predict early cisplatin-related nephrotoxicity in locally advanced head and neck cancer patients treated with chemoradiation: A single Institution experience

Objectives: Cisplatin is essential in the curative treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) patients. The assessment of risk factors to predict an early cisplatin-induced nephrotoxicity could help in better managing one of the most relevant cisplatin-related dose-limiting factors. Material and methods: We retrospectively collected data of LA-HNSCC patients treated at our Institution from 2008 to 2019. Patients received cisplatin in a curative setting concurrently with radiation. Acute Kidney Injury (AKI) was assessed as a dichotomous variable (CreaIncr) based on pre-treatment values, and values recorded at days 6-20 post-first cycle of cisplatin. Univariable logistic regression models were performed to investigate associations between CreaIncr and clinical characteristics. A multivariable logistic model on a priori selected putative covariates was performed. Results: Of the 350 LA-HNSCC treated patients, 204 were analyzed. Ninety (44 %) suffered from any grade AKI (grade I 51.1 %): out of them, 84.4 % received high-dose cisplatin (100 mg/m2 q21). On the univariable logistic regression model, male sex, age, serum uric acid, creatinine, concomitant drugs, and cisplatin schedule were significantly associated with a higher rate of AKI. At multivariable model, age (p = 0.034), baseline creatinine (p = 0.027), concomitant drugs (p = 0.043), and cisplatin schedule (one-day bolus or fractionated high-dose vs. weekly; p = 0.001) maintained their significant association. Conclusions: Identifying pre-treatment risk factors in LA-HNSCC patients may improve decision-making in a setting where cisplatin has a curative significance. A strict monitoring of AKI could avoid cisplatin dose adjustments, interruptions, and treatment delays, thus limiting a negative impact on outcomes

UAV based Narrowband - Internet of things

in this thesis we simulated via Java and Matlab environments a scenario in which a single drone is exploited to carry the NB-IoT base station over an a-priori known area. More specifically, we examined the performance of a drone flying over a area where IoT devices are grouped in clusters and trying to serve as many nodes as possible, with the trajectory solved exploiting the well-known solution of the Travel Salesman Problem (TSP), through which the UAV, that in this study we consider starting from the center of a cluster, finds the minimum path to subsequently reach the center of all the other clusters before reaching again the starting point, where the flight is considered ended. Starting from this assumption we wanted to find the scenario that can best benefit from joint use of NB-IoT and UAV, analyzing both its network throughput and how resources are scheduled by this standard. Then we want to compare the previous results with the new ones obtained changing the way random access is simulated in the code

From Molecular Spectra to Biological Activities: a Comparative Spectra Analysis (CoSA) study on Epidermal Growth Factor Receptor Protein Tyrosine Kinase Inhibitors

Abstract not availabl