Gli interventi educativi per i pazienti con scompenso cardiaco: una sintesi della letteratura

Patient education is recognized as a central component of heart failure care and reduces hospital readmissions. Nurses have an important role in providing patient education and modifying self-care behaviors. The aim of this article is to examine characteristics of educational interventions for heart failure patients, their measured outcomes and the role of nurses in providing education. We conducted a literature review of the last 10 years and considered 30 articles. Multisession motivational interventions, repeated over time and with different follow-up interventions seem to produce the best results. However, some aspects remain controversial

Monitoring of masonry historical constructions: 10 years of static monitoring of the world's largest oval dome

This paper presents the analyses conducted on the data acquired by the monitoring system of the “Regina Montis Regalis” Basilica of Vicoforte (Italy) in the decade 2004–2014. The Basilica is a building of great historical, architectural, and structural significance, owing its fame to its impressive masonry oval dome, the world's largest of this shape (internal axes of 37.23 by 24.89 m). The dome-drum system of the Basilica has suffered over the years of significant structural problems, partly due to the settlements of the building induced progressively by newly built masses and also to the sliding of the underground. In 1983, concerns over the severe settlements and cracking phenomena affecting the structure prompted the decision to undertake strengthening interventions. A special hooping system, consisting of 56 tie bars, placed around the oval perimeter of the dome, was thus conceived to limit the crack opening. The monitoring system of the Basilica installed in the early 1980s underwent several renovations, and in 2004, its acquisition procedure was automatized. One hundred twelve instruments, consisting of temperature sensors, crackmeters, load cells, pressure cells, wire gauges, hygrometer, piezometers, and hydrometer, are currently installed on the Basilica. This study is primarily focused on data acquired by the crackmeters, the extensometers along the main axes of dome, and the load cells placed at the ends of the tie bars. The main aim of the reported analysis is to evaluate the possible progression of the cracks on the Basilica, and the structural performance of the strengthening interventions put in place in 1985–1987

Passive ocean acoustic tomography: theory and experiment

In this paper the Passive Ocean Acoustic Tomography (P-OAT) methodology is presented. This technique, avoiding the use of a dedicated active sound source, estimates the sea water temperature spatial distribution from the received noise emitted from ships of opportunity. The feasibility of the proposed methodology has been confirmed both by test-runs on semi-synthetic data and by the use of real acoustic and environmental data collected during INTIMATE00 experiment performed on October 2000 in the Atlantic Ocean off the Portuguese coasts

Communication with the public in the health-care system: a descriptive study of the use of social media in Local Health Authorities and public hospitals in Italy

Introduction. In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN) to equip themselves with instruments. Objectives. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL) and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. Materials and methods. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. Results. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. Conclusions. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field

Pressure injury progression and factors associated with different end-points in a home palliative care setting : a retrospective chart review study

CONTEXT: Patients with advanced illnesses show the highest prevalence for pressure injuries. In the palliative care setting, the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. OBJECTIVES: To describe the course of healing for pressure injuries in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement. METHODS: Four-year retrospective chart review of 669 patients cared for in a home palliative care service, of those 124 patients (18.5%) had at least one pressure injury with a survival rate less than or equal to six months. RESULTS: The proportion of healed pressure injuries was 24.4%. Of the injuries not healed, 34.0% were in a maintenance phase, whereas 63.6% were in a process of deterioration. Body mass index (P = 0.0014), artificial nutrition (P = 0.002), and age <70 years (P = 0.022) emerged as predictive factors of pressure injury complete healing. Artificial nutrition, age, male caregiver (P = 0.034), and spouse (P = 0.036) were factors significantly associated with a more rapid pressure injury healing. Continuous deep sedation was a predictive factor for pressure injury deterioration and significantly associated with a more rapid worsening. CONCLUSION: Pressure injury healing is a realistic aim in home palliative care, particularly for injuries not exceeding Stage II occurring at least two weeks before death. When assessing pressure injuries, our results highlight the need to also pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender

The Wounded Healer: A Phenomenological Study on Hospital Nurses Who Contracted COVID-19

Since the pandemic began nurses were at the forefront of the crisis, assisting countless COVID-19 patients, facing unpreparedness, social and family isolation, and lack of protective equipment. Of all health professionals, nurses were those most frequently infected. Research on healthcare professionals' experience of the pandemic and how it may have influenced their life and work is sparse. No study has focused on the experiences of nurses who contracted COVID-19 and afterwards returned to caring for patients with COVID-19. The purpose of this study was therefore to explore the lived personal and professional experiences of such nurses, and to describe the impact it had on their ways of approaching patients, caring for them, and practicing their profession. A phenomenological study was conducted with 54 nurses, through 20 individual interviews and 4 focus groups. The main finding is that the nurses who contracted COVID-19 became "wounded healers": they survived and recovered, but remained "wounded" by the experience, and returned to caring for patients as "healers," with increased compassion and attention to basic needs. Through this life-changing experience they strengthened their ability to build therapeutic relationships with patients and re-discovered fundamental values of nursing. These are some of the ways in which nurses can express most profoundly the ethics of work done well

Prolonged remission of disseminated atypical adenomatous hyperplasia under gefitinib.

Abstract:Atypical adenomatous hyperplasia (AAH) is a putative precursor of bronchioloalveolar carcinoma (BAC) and adenocarcinoma of the lung, developing from terminal respiratory unit cells. AAH and BAC lesions typically present as ground-glass opacities at spiral chest computed tomography. Epidermal growth factor receptor polysomy/mutations, conferring higher sensitivity to Gefitinib, are frequent in BAC but less common in AAH. We describe an interesting case of disseminated AAH showing a sustained remission under Gefitinib therapy