Screening chest radiography: results from a Greek cross-sectional survey

BACKGROUND: Public health authorities worldwide discourage the use of chest radiography as a screening modality, as the diagnostic performance of chest radiography does not justify its application for screening and may even be harmful, since people with false positive results may experience anxiety and concern. Despite the accumulated evidence, various reports suggest that primary care physicians throughout the world still prescribe chest radiography for screening. We therefore set out to index the use of chest radiography for screening purposes among the healthy adult population and to analyze its relationship with possible trigger factors. METHODS: The study was designed as a cross-sectional survey. Five thousand four hundred and ninety-nine healthy adults, coming from 26 Greek provinces were surveyed for screening practice habits in the nationwide anticancer study. Data were obtained for the use of screening chest radiography. Impact of age, gender, tobacco exposure, family history positive for malignancies and professional-risk for lung diseases was further analyzed. RESULTS: we found that 20% (n = 1099) of the surveyed individuals underwent chest radiography for screening purposes for at least one time during the previous three years. Among those, 24% do so with a frequency equal or higher than once yearly, and 48% with a frequency equal or higher than every three years. Screening for chest radiography was more commonly adopted among males (OR 1.130, 95% CI 0.988–1.292), pensioners (OR 1.319, CI 1.093–1.593) and individuals with a positive family history for lung cancer (OR 1.251, CI 0.988–1.583). Multivariate analysis confirmed these results. CONCLUSION: Despite formal recommendations, chest radiography for screening purposes was a common practice among the analyzed sample of Greek adults. This practice is of questionable value since the positive predictive value of chest radiography is low. The implementation of even a relatively inexpensive imaging study on a national scale would greatly burden health economics and the workload of radiology departments

Time-trend of melanoma screening practice by primary care physicians: A meta-regression analysis

Objective. To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time. Methods. Meta-regression analyses of available data. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials. Results. Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%\u201382% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were 120.68% (P =0.494), 122.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines. Conclusions. Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon

Midwifery Education Institutions in Italy Creation and Validation of Clinical Preceptors’ Assessment Tool: Students’ and Expert Midwives’ Views

Background: The aim of the study is to create and validate a midwifery preceptor’s evaluation form to be used by midwifery students. The International Confederation of Midwives recommends that clinical placements need to be supervised by a preceptor in order to be efficient for students who, in this way, gain competence and proper practice within the midwifery practical area. Methods: This is an observational multi-center transversal study and leads to the validation of an evaluation questionnaire. Methodically, the following steps were followed: literature review, focus group with midwifery students, meeting between expert midwives, creation of the preceptor’s assessment form, filling in of the forms by midwifery students and expert midwives, and validation of the form. The study was carried out in eight Italian universities and included eighty-eight midwifery students and eight midwives. Results and Conclusion: A midwifery preceptor’s assessment questionnaire was created made up of four attribute areas which, as a total, included 33 items. Cronbach’s alpha score was calculated after examining the forms filled in by students and expert midwives. An alpha score of 0.97–0.85 was obtained. The result was Pearson Correlation Coefficient r = 0.78

Effects of Red Blood Cell Transfusions on the Risk of Developing Complications or Death: An Observational Study of a Cohort of Very Low Birth Weight Infants

Background The aim of this study was to evaluate the association between red blood cell (RBC) transfusions on the risk of death, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. Study Design and Methods This is an observational study. Data were entered prospectively into the study database at the time of the first transfusion. Clinical characteristics, adverse events, and outcomes of the patients transfused in the first 28 days of life were compared with the population of VLBW infants not transfused during the same period. The association among birth weight, gestational age, comorbidities, and the number of transfusions was estimated with a Poisson regression model. The association between the composite outcome and the occurrence of death, ROP, or BPD separately considered and a set of covariates was estimated with a logistic regression model. Results We enrolled 641 VLBW infants, 42% of whom were transfused. Transfusions were associated with the risk of developing the composite outcome, independently from other conditions; this risk correlated with several transfusions \ue2\u89\ua5 3 (odds ratio: 5.88, 95% confidence interval: 2.74-12.6). ROP and BPD were associated with several transfusions \ue2\u89\ua5 3. Conclusion We observed an association between RBC transfusions and the composite risk of death or ROP, BPD, and NEC

Validation and Analysis of the European Quality Questionnaire in Italian Language

The European Quality Questionnaire (euroQ2) is the culturally-adapted version to the European context of the Family Satisfaction in Intensive Care Unit (FS-ICU) and Quality of Dying and Death (QODD) tools in a single instrument divided into three parts (the last is optional). These tools were created for an adult setting. The aim of this study was the Italian validation and analysis of the euroQ2 tool. The Italian version of euroQ2 questionnaire was administered to the relatives, over 18 years of age, of adult intensive care unit patients, with the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale—Revised (IES-r). For the re-test phase the questionnaire was administered a second time. One hundred questionnaires were filled in. The agreement between test and retest was between 17–19 out of 20 participants with an upward trend in the re-test phase. A measure of coherence and cohesion between the euroQ2 variables was given by Cronbach’s alpha: in the first part of the questionnaire alpha was 0.82, in the second part it was 0.89. The linear Pearson’s correlation coefficients between all questions showed a weak positive correlation. The results obtained agreed with the original study. This study showed a good stability of the answers, an indication of an unambiguous understanding of the Italian translation

Realizzazione della versione italiana del Dichotic Digit Test

Il Dichotic Digit Test (DDT) \ue8 un test uditivo centrale, ideato da Frank Musiek nel 1982, che valuta in poco tempo e facilmente la capacit\ue0 di integrazione binaurale. Il DDT testa la capacit\ue0 dell'ascoltatore di elaborare informazioni differenti che sono presentate contemporaneamente in ciascun orecchio, \ue8 stato tradotto in molte lingue ad eccezione dell\u2019italiano ed \ue8 somministrabile ad adulti e bambini. Il nostro obiettivo \ue8 stato quello di realizzare il DDT in italiano in modo che avesse le stesse caratteristiche del test inglese di Musiek al fine di poter integrare il DTT nei diagnostica audiologica dei processi uditivi centrali. Nella prima fase dello studio, abbiamo realizzato diverse versioni del test che sono state poi testate (test-retest) in un gruppo di 20 volontari sani di et\ue0 compresa tra i 19 e i 53 anni (et\ue0 media 24,4 \ub17,72) al fine di defininire la versione definitiva del DDT. Questa versione \ue8 stata poi applicata in un gruppo di 231 soggetti in et\ue0 scolare (6-10 anni). Il DDT \ue8 stato in grado di evidenziare in tutti i casi il noto vantaggio orecchio destro (REA), I risultati ottenuti hanno dimostrato che la versione italiana del DDT ha fornito risultati comparabili con la versione inglese di Musiek. La riproducibilit\ue0 al test-retest, valutata attraverso il coefficiente di correlazione intraclasse (ICC) calcolato come varianza intra-soggetto sulla varianza totale \ue8 risultato essere pari a 0.89. Il test \ue8 risultato valido, affidabile e riproducibile anche in et\ue0 pediatrica. Sono stati poi analizzati i fattori che condizionano le risposte al test in et\ue0 scolare