European survey on knowledge and attitudes of public health professionals on public health genomics: pilot study

Background: During the past decade a debate has arisen on the possible utility of genomic science for public health purposes. Within this context, a survey is being conducted to assess attitudes of European public health (PH) professionals belonging to European Public Health Association (EUPHA) network regarding their role in the implementation of public health genomics (PHG), and their knowledge and attitudes regarding genetic testing and the delivery of genetic services. Methods: A pilot on-line survey was conducted on professionals from Sapienza University of Rome and the Vrije University of Amsterdam. The survey tool is composed of 5 sections: Personal details, Professional activity, Knowledge on genetic testing and delivery of genetic services, Attitudes on genetic testing and delivery of genetic services, Attitudes on the role of PH professionals in PHG. Results: 34 people responded to the questionnaire, mostly medical doctors (61.8%). No respondents correctly identified all evidence-based applications of genetic testing. More than one third of respondents agreed that it would be more important to invest resources in the social and environmental causes of ill health than in genetic testing. Nearly 70% thought that PHG needs to be grounded on evidence of effectiveness, a lower rate agreed ii should be grounded on cost-effectiveness. The rate of agreement with the proposed roles of PH professionals in PHG was very high. Conclusion: This pilot study showed a positive attitude but the need to improve knowledge of PH professionals on PHG. It provided useful input for the implementation of the survey to all members of the EUPHA network

Which BRCA genetic testing programs are ready for implementation in health care? A systematic review of economic evaluations

Purpose: There is considerable evidence regarding the efficacy and effectiveness of BRCA genetic testing programs, but whether they represent good use of financial resources is not clear. Therefore, we aimed to identify the main health-care programs for BRCA testing and to evaluate their cost-effectiveness. Methods: We performed a systematic review of full economic evaluations of health-care programs involving BRCA testing. Results: Nine economic evaluations were included, and four main categories of BRCA testing programs were identified: (i) populationbased genetic screening of individuals without cancer, either comprehensive or targeted based on ancestry; (ii) family history (FH)-based genetic screening, i.e., testing individuals without cancer but with FH suggestive of BRCA mutation; (iii) familial mutation (FM)- based genetic screening, i.e., testing individuals without cancer but with known familial BRCA mutation; and (iv) cancer-based genetic screening, i.e., testing individuals with BRCA-related cancers. Conclusions: Currently BRCA1/2 population-based screening represents good value for the money among Ashkenazi Jews only. FHbased screening is potentially very cost-effective, although further studies that include costs of identifying high-risk women are needed. There is no evidence of cost-effectiveness for BRCA screening of all newly diagnosed cases of breast/ovarian cancers followed by cascade testing of relatives, but programs that include tools for identifying affected women at higher risk for inherited forms are promising. Cost-effectiveness is highly sensitive to the cost of BRCA1/2 testing

Knowledge, attitudes, behaviour and training needs of ICU nurses on medication errors in the use of IV drugs: a pilot study

Background. Prior studies have shown that lack of knowledge and training, incorrect behaviours and attitudes put Intensive care unit (ICU) patients at risk. The aim of this study was to assess knowledge, attitudes and professional behaviour of Italian nurses towards preparation and administration of intravenous medications in ICUs. Reliability and validity of the questionnaire were assessed as well. Methods. A survey was conducted on a sample of Italian nurses in 2015 through a self-administered questionnaire. Reliability was tested and content validity was evaluated using Cronbach’s alpha. Multiple logistic regression models were built to identify predictors of knowledge, attitudes and behaviours. Results. In total, 123 nurses completed the questionnaire. For the variable ‘adequate knowledge’ nurses were divided in those who had correctly answered 7 of 8 questions on knowledge and everyone else, while for ‘attitudes and professional behaviour’ responders were grouped into those who showed a positive attitude and appropriate behaviour and everyone else. Results of the multiple logistic regression analyses show some association, although not statistically significant, between correct behaviour, positive attitudes and the years of work experience. It is interesting to note that appropriate knowledge weighs negatively on correct behaviour (OR 0.06, 95% CI 0.04-0.42). Moreover, graduate nurses have more appropriate knowledge than those who are not. A high level of interest for specific training was reported by almost all responders. Cronbach’s alpha for all three sections together resulted in a value of 0.49. Conclusions.This pilot study demonstrated the need to amend the questionnaire, especially the knowledge and behaviour sections, in which the Cronbach’s alpha was less than 0.7. Targeted educational programs are needed to improve the expertise of nurses to reduce medication errors during preparation and administration of IV medications in the ICU

Anomalous evolution of broadband optical absorption reveals dynamic solid state reorganization during eumelanin build-up in thin films

The origin of eumelanin optical properties remains a formidable conundrum preventing a detailed understanding of the complex photo-protective role of these widespread natural pigments and the rational design of innovative bioinspired materials for optoelectronic applications. Here we report the unusual kinetic and thickness-dependent evolution of the optical properties of black eumelanin polymers generated by spontaneous aerial polymerization of 5,6-dihydroxyindole (DHI) thin films (0.1-1 μm), consistent with peculiar solid state reorganization mechanisms governing broadband absorption. The complete reversal of eumelanin UV-visible transmittance spectrum curvature on passing from 0.2 to 0.5 μm thick films, the marked increase in visible extinction coefficients with increasing film thickness and the higher UV extinction coefficients in slowly vs. rapidly generated polymers concur to support distinct dynamic regimes of solid-state molecular reorganization at the nanoscale level and to do affect the development of broadband visible absorption. Solid state control of molecular reorganization disclosed herein may delineate new rational strategies for tuning optical properties in eumelanin thin films for optoelectronic applications

Are knowledge and skills acquired during the Master Degree in Nursing actually put into practice? A pilot study in Italy

Background. Literature on the evaluation of the Master’s Degree in Nursing is scarce. The objective of this pilot study was to test a questionnaire aimed at monitoring the activities of nurses after receiving the Master’s degree. Methods. An electronic questionnaire was administered to 36 graduates who obtained the Master’s degree during the academic year 2010/2011. Results. Almost 80% of the participants judged their level of improvement in knowledge and skills during the course to have been satisfactory, but the level of implementation of these competencies at work was quite low. Conclusion. Competencies acquired during the Master’s degree course are not always put into practice

Benefits of parent training in the rehabilitation of deaf or hard of hearing children of hearing parents: a systematic review

The present study is a systematic review on the effectiveness of Parent Training (PT) and coaching in deaf and hard of hearing (DHH) rehabilitation programs which reviews and synthesizes the existing body of evidence to assess the benefits of these programs in enhancing parents’ sensitivity, responsivity and promoting language development in DHH children during the first years after HA fitting or CI activation. Five published studies met the Population, Intervention, Comparison and Outcomes (PICO) inclusion criteria and were eligible to be included, but heterogeneity in terms of the study design, interventions and outcomes did not allow for performing a meta-analysis. All included studies shared the view that a parent’s learning is a circular (rather than frontal) process, and the results appear promising in terms of enhancing parents’ responsiveness and promoting DHH child language development. Nevertheless, the available evidence was judged to not be robust enough due to limitations in the studies’ designs. Further high-quality evidence is needed to evaluate the true degree of clinical value and the cost effectiveness of PT programs aimed at increasing parents’ responsiveness to their DHH childre

Periostin expression in uninvolved skin as a potential biomarker for rapid cutaneous progression in systemic sclerosis patients: a preliminary explorative study

ObjectivesThis study aimed to evaluate periostin serum levels and skin expression in patients with systemic sclerosis (SSc).MethodsWe enrolled 35 patients with diffuse (d-SSc) or limited (l-SSc) SSc, 15 patients with very early diagnosis of systemic sclerosis (VEDOSS), and 30 sex-matched healthy controls. Periostin serum levels were determined by an enzyme-linked immunosorbent assay (ELISA). Periostin skin expression was determined by immunohistochemistry (IHC) on paired involved and uninvolved 5-mm skin biopsy samples in a subgroup of 10 d-SSc and 10 L-SSc patients. A 12-month follow-up was considered.ResultsWe included 50 patients (mean age 53.1 ± 16.1 years; women 94%; mean disease duration 38.2 ± 45.1 months; anti-centromere 50%; anti-Scl70 40%), 35 of them with a definite SSc (68.8% l-SSc; 31.4% d-SSc; mean mRSS 9.0 ± 7.2) and 15 with VEDOSS; 30 controls were also included in this study. Periostin serum levels were higher in SSc patients compared to controls (32.7 ± 8.0 ng/mL vs. 27.7 ± 7.3 ng/mL; p < 0.001), while these levels were comparable among different groups of patients (29.7 ± 6.9 ng/mL in VEDOSS, 33.4 ± 7.8 ng/mL in lc-SSc; and 34.0 ± 8.5 in dc-SSc; p = ns). SSc patients with digital ulcers had higher periostin serum levels (36.2 ± 7.9 ng/mL vs. 30.6 ± 7.3 ng/mL, p < 0.02). Samples from the involved skin of l-SSc and d-SSc patients showed a significant dermal expression of periostin; an identical periostin expression was evident in the uninvolved skin of patients with d-SSc. In 7 out of 10 L-SSc patients, periostin expression was absent on uninvolved skin. In the remaining three l-SSc patients, a mild periostin expression on IHC was detectable on uninvolved skin and all of these three l-SSc patients presented a dramatic skin progression.ConclusionPeriostin skin expression may be a useful biomarker to indicate the presence of a disease at a higher risk of rapid cutaneous involvement