L'esperienza dei caregiver primari che assistono a domicilio le persone affette dalla Malattia di Alzheimer

RIASSUNTO Nel presente studio si vuole indagare quale sia l'esperienza dei caregiver (uomini e donne) primari delle persone affette da Malattia di Alzheimer in ambito domiciliare. Obiettivo dello studio è di discutere su come i caregivers vivano la loro esperienza di fornitori di assistenza in modo da poter mettere in atto programmi che possano contribuire al miglioramento dell'esperienza assistenziale e personale. Per lo studio è stato utilizzato un metodo qualitativo e il campione è stato definito in base alla saturazione dei dati. Le interviste, effettuate presso un Centro Diurno, sono state registrate, trascritte verbatim ed analizzate in modo rigoroso per estrapolare i temi fondamentali dell'esperienza. Dall'analisi delle stesse sono stati estratti i concetti costitutivi (codici sostanziali) e sono stati raggruppati in categorie simili con l'estrapolazione di sei temi fondamentali. I nostri risultati sono in accordo con la letteratura ove esiste un generale consenso relativo alle problematiche riguardanti l'esperienza di caregiving. Alla luce dei risultati si pongono le basi per strutturare un modello riferito al Nursing che necessiterí  di ulteriore analisi e futura validazione. Parole chiave: caregiver, infermieristica, ricerca qualitativa, sindrome di AlzheimerAbstractThe aim of this study is to investigate the experience of primary caregivers (men and women) of Alzheimer Disease dementia, in order to tailor program and project to avoid care giving burden. A qualitative phenomenological method was used and the sample was defined by data saturation. Interviews were carried out and recorded in a day care Centre, transcribed verbatim. The analysis was conducted coding common themes and phrases. Six main themes emerged. Our results are similar to those existing in literature, showing care givers as individual in great danger physically and mentally. In the light of the study it is possible to tailor a nursing model in order to improve quality of life and decrease the burden of caregivers, this model should be implemented and analyzed.Keyword: Caregiver, burden, qualitative research, Alzheimer Diseas

Ultrasound-guided removal of soft tissue foreign bodies in companion animals: A case series

Foreign bodies (FBs) retained in the subcutaneous tissues are a common reason for medical consultation. In small animals, FBs usually consist of vegetal materials, especially grass awns. Failure to remove the FBs is likely to give rise to acute or late complications. The surgical removal of the FBs can be invasive, costly and technically challenging. Ultrasound has become a mainstay in the detection of FBs and it can be used to guide the extraction of the FBs with a minimally invasive technique. This study describes the detection and extraction of soft-tissue FBs in small animals. One hundred-sixty-two patients, presenting at two veterinary clinics with suspected FBs retained in the soft tissues of various body districts, were considered. Once an ultrasound diagnosis was established, the ultrasound-guided removal of the FB was performed. A high-frequency linear transducer, a skin disinfection, sedation or anaesthesia was used when needed and a scalpel and some Hartmann forceps were also used. One hundred-eighty-two FBs were successfully removed in all the patients. In six cases, the FB was identified during a second ultrasonographic examination, after recurrence of the fistula. No complications were reported after the procedure. The extraction of the FB was performed in an echographic suite in 138 cases and in a surgery room with surgical intervention in 24 cases. In the latter situation, the surgical minimally invasive dissection of tissues under ultrasound guidance was performed before the removal of the FB. In conclusion, the ultrasound-guided removal of the FBs retained in the superficial soft tissue can be considered a good alternative to surgery. However, failure to remove a FB does not preclude the removal by traditional surgery

COMPARISON OF PLAIN RADIOGRAPHY AND COMPUTED TOMOGRAPHY FOR DETECTION OF ELBOW DYSPLASIA IN LABRADOR RETRIEVER

To our knowledge there has been no comprehensive direct comparison between the plain radiology and computed tomography (CT) for diagnosis of elbow dysplasia through the use of a grading score. The first aim of the study was to clinically apply a comparative grid (proposed at the last IEWG meeting in 2016) to grade elbow dysplasia on CT similarly as is done on traditional radiology. The second objective was to evaluate the concordance of the grading between the two imaging modalities at the age less than 12 months and over 12 months and to emphasise the differences observed between puppies and adult dogs. Thirty-nine (39) Labrador Retriever (78 elbow joints) were included in the study, the dogs were own client dogs, asymptomatic, no one showed any sign of lameness nor other clinical problems. At the age 12months the agreement was fair too with K 0.23 and the sensitivity was 70% and specificity 98% (P<0.001). A development of the disease has been noted between the evaluations at different ages. On plain radiography the grade of disease worsened in 24 elbow joint and improved in 2 (P 0.001). On CT the grade of the disease remained invariable in 54 joints and showed a worse grade in 19 joints and improved in 5 joints (P 0.004). Further studies including also other breeds might provide more information about the accurate use of a score grading on CT. The presence of false-negatives in our group of dogs and the fair agreement between the two modalities open a discussion about the exclusive use of radiographs in the screening program. As well a screening program to treat dogs at too young an age should be reassessed having regard to the disease progression, which, however is not related to any clinical symptoms

Lifestyle-Related Risk Factors of Orthorexia Can Differ among the Students of Distinct University Courses

Orthorexia nervosa (ON) is defined as the excessive attention on healthy eating, and studies especially focused on food quality ON prevalence in university students can be extremely variable. The objective of this study is to investigate whether there was a difference in ON risk between health-scientific, economic-humanistic, sport sciences and dietetics and nutrition students, and to evaluate if lifestyle-related ON risk factors (dieting, physical activity, drugs and supplements use) could have an impact in different ways in determining ON risk among students attending these four programs. Participants were recruited at the University of Pavia and received a two-section questionnaire including demographic and lifestyle information and the ORTO-15 questionnaire. A total of 671 students (54% F e 46% M) completed the questionnaire (median age 21.00 (IQR 20.00&ndash;23.00), median BMI 21.77 kg/m2 (IQR 20.06&ndash;23.66 kg/m2)). The 31.2% had ORTO-15 test scores &lt; 35, and were considered at risk of having ON. No differences were found in ON risk among the students attending the four university courses. Dieting was confirmed as the major ON risk factor for health-scientific, economic-humanistic and sport sciences students. The type of sport practiced was an important determinant of ON risk only for the economic-humanistic course, while supplements use was statistically different between sport sciences students with or without ON. Our findings may suggest that lifestyle-related risk factors of orthorexia can differ among the students of distinct university courses, but these results need to be supported by further longitudinal and prospective studies