Sleep actigraphic patterns and cognitive status

none9noWe performed an actigraphic assessment of sleep characteristics in healthy subjects and patients with cognitive impairment. Thirty subjects were included and classified into controls (10 subjects), mild cognitive impairment (10 patients) and mild-to-moderate Alzheimer's disease (10 patients). Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Participants had a 7-day actigraphic record. Sleep parameters collected were time in bed, total sleep time, sleep efficiency, sleep latency, wakefulness after sleep onset, number of awakenings, and mean motor activity. Significant differences between mild cognitive impairment and controls patients were found for sleep latency (p = 0.05); Alzheimer's disease patients had significantly worse scores for Pittsburgh Sleep Quality Index (p = 0.01), time in bed (p = 0.001), total sleep time (p = 0.04), sleep latency, sleep efficiency, motor activity (p = 0.0001) and wakefulness after sleep onset (p = 0.001) compared to controls. When comparing Alzheimer's disease and mild cognitive impairment, differences were significant for sleep latency (p = 0.01), wakefulness after sleep onset (p = 0.004), sleep efficiency, number of awakenings and motor activity (p = 0.0001). In addition to showing a high prevalence of sleep alterations in subjects with cognitive impairment, our data suggest that they are evident from the earliest stages of cognitive decline. Further studies are needed to assess whether early correction of sleep alterations can positively influence the evolution of cognitive impairment. The opportunity to provide clinically meaningful information with a simple assessment of sleep characteristics based on actigraphy suggests that wider use of the approach in patients with cognitive decline should be considered.openBuratti, Laura; Camilletti, Roberta; Pulcini, Alessandra; Rocchi, Chiara; Viticchi, Giovanna; Falsetti, Lorenzo; Baldinelli, Sara; Fiori, Chiara; Silvestrini, MauroBuratti, Laura; Camilletti, Roberta; Pulcini, Alessandra; Rocchi, Chiara; Viticchi, Giovanna; Falsetti, Lorenzo; Baldinelli, Sara; Fiori, Chiara; Silvestrini, Maur

Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice

Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives

Advanced Practice Nursing in Latin America and the Caribbean: Regulation, Education and Practice

OBJECTIVE: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. METHOD: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. RESULT: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries\u27 populations could benefit from an advanced practice nursing role in primary health care. CONCLUSION: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. OBJETIVO: identificar o estado atual da regulação, educação e prática do enfermeiro de prática avançada na América Latina e no Caribe e a percepção de líderes de enfermagem na região quanto ao papel da enfermagem de prática avançada na atenção primaria à saúde em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. MÉTODO: o estudo descritivo transversal utilizou um survey online com 173 líderes de enfermagem questionando suas percepções sobre o estado atual da prática de enfermagem e o potencial desenvolvimento da enfermagem de prática avançada em seus países, incluindo a definição do termo, o ambiente de trabalho, a regulação, educação, prática, cultura de enfermagem e receptividade percebida de um papel mais amplo deste profissional na atenção primaria à saúde. RESULTADO: os participantes referiram estar familiarizados com o papel do enfermeiro de prática avançada, mas a maioria não sabia ou não relatou a legislação vigente para o papel da prática avançada em seus países. Os participantes relataram a necessidade de aumentar a preparação do corpo docente e promover reformas curriculares com enfase na atenção primária à saúde para formar enfermeiros de prática avançada. A grande maioria dos participantes acredita que as populações de seus países se beneficiará com o papel do enfermeiro de prática avançada na atenção primária à saúde. CONCLUSÃO: forte apoio em termos de legislação e uma estrutura educacional sólida de formação contínua são fundamentais para o êxito do desenvolvimento de programas de enfermagem de prática avançada em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. OBJETIVO: identificar el estado actual de la regulación, educación y práctica de la enfermera de práctica avanzada en Latinoamérica y el Caribe y la percepción de los líderes de enfermería en la región hacia un rol de práctica avanzada de enfermería dentro de la atención primaria de salud para apoyar las iniciativas de Acceso Universal a la Salud y la Cobertura Universal de Salud. MÉTODO: un diseño transversal descriptivo que utilizó una encuesta basada en la web a 173 líderes de enfermería acerca de sus percepciones sobre el estado de la enfermería y el desarrollo potencial de la práctica avanzada de enfermería en sus países, incluyendo definición, ambiente laboral, regulación, educación, práctica de enfermería, cultura de enfermería y la receptividad percibida a un papel más amplio en atención primaria de salud. RESULTADO: los participantes estaban ampliamente familiarizados con el rol de la enfermera de práctica avanzada, pero la mayoría desconocía la legislación o reportaba no existencia actual de legislación para el rol de práctica avanzada en sus países. Los participantes reportaron la necesidad de aumentar la preparación docente y reformas curriculares para apoyar programas de atención primaria de salud para capacitar las enfermeras de práctica avanzada. La gran mayoría de los participantes creían que las poblaciones de sus países se podrían beneficiar de un rol de práctica avanzada de enfermería en atención primaria de salud. CONCLUSIÓN: un fuerte apoyo legislativo y un marco educacional sólido que continúen informándose entre sí, son críticos para el desarrollo exitoso de programas de práctica avanzada y de nurse practitioners para apoyar las iniciativas de Acceso Universal a la Salud y Cobertura Universal de Salud

Black lymph node in tattoo: an easy pitfall

Tattoo is one of the most popular body arts in the world. It may be considered as a sign of belonging to a particular community as well as an expression of masculinity. However, it may also have a mere aesthetic purpose. In the past, whereas tattooing was common for male military personnel, bourgeois society spurned it. Nowadays, it is estimated that more than 24% of American adults have at least a tattoo.1 It is trending so tattooing is increasing social acceptability. The practice is equally common in men and women. In Italy, this phenomenon is less extensive than in America. However, it is definitely on the rise if we compare it with the past. Tattooing is becoming extremely popular with adolescent

Impact of COVID-19 on Oral Cancer Diagnosis: A Systematic Review

The Coronavirus-19 pandemic has led to severe collapses in international health systems that have repercussions at all levels of disease prevention. Oral squamous cell carcinoma (OSCC) is the most common head / neck malignancy, and it is usually diagnosed late due to patients neglecting symptoms. The purpose of this systematic review is to verify the impact of Sars-Cov-2 pandemic on OSCC diagnosis. The search methodology follows the PRISMA statement performing a PubMed investigation from 2019 to 2021 using MeSH such as "Covid-19; oral cancer". A multidisciplinary approach would be effective, with a broadening of the knowledge of health professionals to identify cancerous lesions. A timely diagnosis of OSCC is crucial and its management is fundamental also for dental specialists. With the aim to anticipate the diagnosis, it will be desirable to set prevention campaigns also by the assistance in telemedicine

Iodine uptake and distribution in horticultural and fruit tree species.

Iodine is an essential microelement for humans and iodine deficiency disorder (IDD) is one of the most widespread nutrient-deficiency diseases in the world. Iodine biofortification of plants provides an attractive opportunity to increase iodine intake in humans and to prevent and control IDD. This study was conducted to investigate the iodine uptake and accumulation in edible portion of two fruit trees: plum and nectarine, and two horticultural crops: tomato and potato. Two type of iodine treatments (soil and foliar spray application), and, for fresh market tomato, two production systems (open field and greenhouse hydroponic culture) were tested. The distribution of iodine in potato stem and leaves, and in plum tree fruits, leaves, and branches was investigated. Iodine content of potato tubers after postharvest storage and processing (cooking), and iodine content of nectarine fruits after postharvest storage and processing (peeling) were also determined. Differences in iodine accumulation were observed among the four crops, between applications, and between production systems. In open field, the maximum iodine content ranged from 9.5 and 14.3 \u3bcg 100 g 121 for plum and nectarine fruit, to 89.4 and 144.0 \u3bcg 100 g 121 for potato tuber and tomato fruit, respectively. These results showed that nectarine and plum tree accumulated significantly lower amounts of iodine in their edible tissues, in comparison with potato and tomato. The experiments also indicated hydroponic culture as the most efficient system for iodine uptake in tomato, since its fresh fruits accumulated up to 2423 \u3bcg 100 g 121 of iodine. Iodine was stored mainly in the leaves, in all species investigated. Only a small portion of iodine was moved to plum tree branches and fruits, and to potato stems and tubers. No differences in iodine content after fruit peeling was observed. A significant increase in iodine content of potato was observed after baking, whereas a significant decrease was observed after boiling. We concluded that iodine biofortified fresh market tomato salad, both from field and hydroponics cultivation, and baked potatoes can be considered as potential functional foods for IDD prevention

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice