The clinical effectiveness of an integrated multidisciplinary evidence-based program to prevent intraoperative pressure injuries in high-risk children undergoing long-duration surgical procedures: a quality improvement study

The prevention of hospital-acquired pressure injuries (HAPIs) in children undergoing long-duration surgical procedures is of critical importance due to the potential for catastrophic sequelae of these generally preventable injuries for the child and their family. Long-duration surgical procedures in children have the potential to result in high rates of HAPI due to physiological factors and the difficulty or impossibility of repositioning these patients intraoperatively. We developed and implemented a multi-modal, multi-disciplinary translational HAPI prevention quality improvement program at a large European Paediatric University Teaching Hospital. The intervention comprised the establishment of wound prevention teams, modified HAPI risk assessment tools, specific education, and the use of prophylactic dressings and fluidized positioners during long-duration surgical procedures. As part of the evaluation of the effectiveness of the program in reducing intraoperative HAPI, we conducted a prospective cohort study of 200 children undergoing long-duration surgical procedures and compared their outcomes with a matched historical cohort of 200 children who had undergone similar surgery the previous year. The findings demonstrated a reduction in HAPI in the intervention cohort of 80% (p < 0.01) compared to the comparator group when controlling for age, pathology, comorbidity, and surgical duration. We believe that the findings demonstrate that it is possible to significantly decrease HAPI incidence in these highly vulnerable children by using an evidence-based, multi-modal, multidisciplinary HAPI prevention strategy

Le procedure stragiudiziali presso l'AGCOM

La seguente tesi consta di una disamina sulle procedure stragiudiziali di risoluzione delle controversie (ADR) proposte dall'autorità per le garanzie nelle comunicazioni (AGCOM). Verrà dato particolare risalto alla procedura telematica - di recente introduzione - che si avvale per il suo espletamento degli strumenti offerti dalla piattaforma ConciliaWeb. Nel corso della trattazione, una prima parte sarà dedicata alla descrizione analitica delle due procedure stragiudiziali offerte dall'AGCOM, ovvero la procedura di conciliazione e quella di definizione delle controversie. Una seconda parte sarà invece dedicata ad analizzare l'attività conciliativa effettivamente svolta in una finestra temporale pluriennale, attraverso un approfondimento basato sui dati raccolti in itinere dall'AGCOM e dal CORECOM Toscano nell'esercizio delle loro funzioni

Impact of COVID-19 pandemic on pediatric patients with epilepsy - The caregiver perspective

The recent COVID-19 pandemic has disrupted care systems around the world. We assessed how the COVID-19 pandemic affected children with epilepsy in Italy, where lockdown measures were applied from March 8 to May 4, 2020. We compiled an Italian-language online survey on changes to healthcare and views on telehealth. Invitations were sent to 6631 contacts of all patients diagnosed with epilepsy within the last 5 years at the BambinoGesu Children's Hospital in Rome. Of the 3321 responses received, 55.6% of patients were seizure-free for at least 1 year before the COVID-19-related lockdown, 74.4% used anti-seizure medications (ASMs), and 59.7% had intellectual disability. Only 10 patients (0.4%) became infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Seizure frequency remained stable for most patients during the lockdown period (increased in 13.2%; decreased in 20.3%), and seizure duration, use of rescue medications, and adherence to treatment were unchanged. Comorbidities were more affected (behavioral problems worsened in 35.8%; sleep disorder worsened in 17.0%). Visits were canceled/postponed for 41.0%, but 25.1% had remote consultation during the lockdown period (93.9% were satisfied). Most responders (67.2%) considered continued remote consultations advantageous. Our responses support that patients/caregivers are willing to embrace telemedicine for some scenarios. (C) 2020 Elsevier Inc. All rights reserved

Immaginare la repubblica. Sovranit\ue0 e rappresentanza nel discorso dei costituenti romani del 1849.

Nel febbraio 1849 nello Stato Pontificio, in seguito alla fuga di papa Pio IX a Gaeta, si insedia un\u2019Assemblea costituente eletta a suffragio universale, che proclama la Repubblica. Analizzando i dibattiti sorti in seno all\u2019Assemblea, nel suo periodo di attivit\ue0, che va dal 5 febbraio al 4 luglio 1849, \ue8 possibile osservare in quali termini, a met\ue0 Ottocento e nel contesto della storia risorgimentale italiana, viene immaginata una repubblica democratica. L\u2019analisi che l'articolo propone intende esaminare, nello specifico, l\u2019elaborazione delle idee di sovranit\ue0 popolare e rappresentanza democratica all\u2019interno del discorso politico dei costituenti romani. Nel seguire le trame concettuali e discorsive che si sviluppano intorno a queste tematiche \ue8 stato possibile rintracciare e approfondire l'affermarsi di due soggetti politici centrali nell'immaginario politico dei patrioti italiani: il popolo e la nazione