Understanding chronic pain in the ubiquitous community: the role of open data

The combined use of social media, open data, and Artificial Intelligence has the potential to support practitioners and empower patients/citizens living with persistent pain, both as local and online communities. Given the wide availability of digital technology today, both practitioners and interested individuals can be connected with virtual communities and can support each other from the comfort of their homes. Digital means may represent new avenues for exploring the complexity of the pain experience. Online interactions of patients, data on effective treatments, and data collected by wearable devices may represent an incredible source of psychological, sociological, and physiological pain-related information. Digital means might provide several solutions that enhance inclusiveness and motivate patients to share personal experiences, limiting the sense of isolation in both rural and metropolitan areas. Building on the consensus of the usefulness of social media in enhancing the understanding of persistent pain and related subjective experiences via online communities and networks, we provide relevant scenarios where the effectiveness and efficiency of healthcare delivery might be improved by the adoption of the digital technologies mentioned above and repeated subsequently. The aim of this perspective paper is to explore the potential of open data, social media, and Artificial Intelligence in improving the prevention and management of persistent pain by adopting innovative non-biomedical approaches

Gender and sex bias in prevention and clinical treatment of women's chronic pain: hypotheses of a curriculum development

This discursive paper focuses on undergraduate medical education's role in tackling gender bias in clinical practice, specifically preventing and managing from a non-biomedical perspective chronic pain in women. A preliminary web search of medical schools' curricula was performed to identify programs content related to gender bias in pain management. The web search included 10 universities' websites selected from the top 10 rankings QS Universities Rankings 2022 for medical schools. Additionally, a questionnaire was sent to all deans of the selected academic institutions to explore the curriculum content further. The web search, and the lack of response from the deans, highlighted that relevant curriculum components on gender bias and chronic pain needed to be implemented. Therefore, this paper introduces an innovative curriculum development approach designed by the multi-professional research team to be implemented in medical school programs. This novel educational strategy could also cross-contaminate other healthcare practitioners' university programs and, thus, stimulate an interprofessional debate into fostering inclusiveness and equal opportunities in health

Peer support between healthcare workers in hospital and out-of-hospital settings: a scoping review

Background and aim: the healthcare workers, mostly in emergency departments, are exposed to emotionally strong situations: this condition often can lead them to operate incorrectly. In the face of the mistake, many of them experience psychological trauma, becoming “second victims” of the event. In this case they can find comfort in dealing with Peers that can help to understand emotions and normalize lived experiences. A scoping review was conducted to clarify the key concepts available in the literature and understand Peer Support characteristics and methods of implementation. Methods: scoping review approach of Joanna Briggs Institute was used. The reviewers analyzed the last twenty-one years of literature and extracted data from relevant studies. Results: 49 articles were relevant. Articles involve mostly physicians and nurses, but all the other healthcare professionals are included. 56% of the articles have been published in the last two years during the Covid 19 pandemic, which revealed the growing need of developing Peer Support programs; the Anglo-Saxon countries are the main geographical area of origin (82%). Peer support emerges as a preclinical psychological support for people involved in tiring situations. It’s based on mutual respect and on voluntary and not prejudicial help. Peers are trained to guide the support relationship. Peer Support can be proposed as one to one/group peer support, or through online platforms. Conclusions: many of the studies affirm that the personnel involved have benefited from the programs available. It is necessary to carry out further research to determine the pre and post intervention benefits. (www.actabiomedica.it)

Early versus Late Tracheostomy Promotes Weaning in Intensive Care Unit Patients

Background and aim of the study: The time interval between the patients’ intubation and the performance of a tracheostomy has been considered as critical for the disease prognosis and outcome. The aim of the present study was to compare and contrast the outcomes of early vs late tracheostomy with regard to intensive care unit (ICU) patients’ weaning from respiratory support. Methods: This retrospective observational study, involved patients who were hospitalized in two general and one Covid-19 ICUs of two tertiary hospitals in Athens and were subjected to tracheostomy. Data were collected from the patients’ medical records in order to estimate the duration of patient weaning and the number of days from the patients’ intubation until the time of tracheostomy. In the present study the term early tracheostomy denotes tracheostomy performed within 14 days from patient intubation and late tracheostomy defines the tracheostomy carried out after 14 days. For Covid-19 patients, guidelines suggested that tracheostomies should be performed 21 days following intubation, due to the high risk of virus transmission. Results: One hundred and thirty-one patients who underwent tracheostomy participated in the study. Most tracheostomies were performed using the percutaneous technique. The group of patients tracheostomized within 14 days after their admission in ICU weaned faster from respiratory support compared to ones who were tracheostomized after 14 days. Conclusions: The most common distinction between early and late tracheostomy is 14 days, with early tracheostomy being more beneficial in terms of patients’ outcomes, and specifically ICU patients’ weaning. (www.actabiomedica.it)

Evidence-based clinical practice guidelines on the management of pain in older people - a summary report.

OBJECTIVE: The objective of this study is to develop an update of the evidence-based guidelines for the management of pain in older people. DESIGN: Review of evidence since 2010 using a systematic and consensus approach is performed. RESULTS: Recognition of the type of pain and routine assessment of pain should inform the use of specific environmental, behavioural and pharmacological interventions. Individualised care plans and analgesic protocols for specific clinical situations, patients and health care settings can be developed from these guidelines. CONCLUSION: Management of pain must be considered as an important component of the health care provided to all people, regardless of their chronological age or severity of illness. By clearly outlining areas where evidence is not available, these guidelines may also stimulate further research. To use the recommended therapeutic approaches, clinicians must be familiar with adverse effects of treatment and the potential for drug interactions

The Effectiveness of NIV and CPAP Training on the Job in COVID-19 Acute Care Wards: A Nurses’ Self-Assessment of Skills

Background: Noninvasive ventilation (NIV) in COVID-19 patients outside of intensive care unit (ICU) settings was a feasible support during the pandemic outbreak. The aim of this study was to assess the effectiveness of an “on the job” NIV training program provided to 66 nurses working in 3 COVID-19 wards in an Italian university hospital. Methods: A quasi-experimental longitudinal before–after study was designed. The NIV Team education program, provided by expert ICU nurses, included: 3 h sessions of training on the job during work-shifts about the management of helmet-continuous positive airway pressure (CPAP) Venturi systems, and NIV with oronasal and full-face masks. An eleven-item “brief skills self-report tool” was administered before and after the program to explore the perception of NIV education program attendees about their level of skills. Results: In total, 59 nurses responded to the questionnaire. There was an improvement in the skill levels of the management of Helmet-CPAP (median before training 2, inter-quartile range (IQR) 0–6; median after training 8, IQR 3–9; p < 0.0001), and mask-NIV (median before training 2, IQR 0–6; median after training 8, IQR 3–9; p < 0.0001). Conclusions: Training on the job performed by expert ICU nurses can be a valuable and fast means to implement new Helmet-CPAP and mask-NIV skills outside of ICUs

Corrigendum to Evidence-based clinical practice guidelines on the management of pain in older people – a summary report

[This corrects the article DOI: 10.1177/2049463720976155.]

The Planning Process Applied to Hospital Companies: How is the Italian Health Care System Changing Face?

Since its creation in 1978 the Italian health care system has been delivering a wide range of services and interventions and it is considered one of the most advanced health organizations among the industrialized countries. In accordance with the Italian Constitution, it provides services free of charge to all without any discrimination. The affirmation of the free choice principle, the progressive introduction of private hospitals and the significant increase in health spending have induced the legislator to introduce cost - effective measures to limit cost and satisfy patients' needs. After having examined the profound changes that have been generally influencing the Italian health care system discover how the San Carlo Hospital of Potenza in Italy is trying to rearrange its strategy to detect patients' needs, reduce cost and face challenges posed by emerging competitors

Simulation: challenges and opportunities along the way of learning

Simulation: what is and what will be. Embark on a stimulating journey into this fascinating topic. Discover when simulation was born and how it has been changing the world surrounding us. Aerospatial industry, higher education, clinical training are some of the most representative settings in which simulation has been playing a vital role to guarantee safe, effective and sustainable procedures. How is simulation able to positively influence the learning process ? Does it have a place in any learning theory ? And if so, does it offer any support to the current educational learning needs towards a lifelong learning ? Are there any significant differences in the way information is retained due to the type of simulation performed ? Considering the learning outcomes, is this information not only more easily retained but also easly transferable, according to the type of simulation ? Explore all of these questions and take part in the debat

Gestational Diabetes Mellitus and Client's Quality of Life: the Role of Continuing Education in Nurses' and Midwifes' Clinical Practice

Expectant mothers who have never had diabetes before in their life and experience elevated blood glucose levels during pregnancy are at risk of developing Gestational Diabetes Mellitus (GDM). What triggers it? Does it harm the mother and the baby? Is continuing education part of a successful strategy to improve quality of care? GDM can be a source of anxiety for pregnant women. In order to relieve anxiety, knowledgeable nurses working hand in hand with other interdisciplinary staff can help to turn the concern into a healthy pregnancy for the mother to be and a healthy life for the newborn