Preliminary testing using Mokken scaling of an Italian translation of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) scale

© 2015 Elsevier Inc. Purpose: To study the psychometric properties of an Italian version of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) Scale. Background: The EdFED Scale is the only validated instrument that measures difficulty with feeding in older people with dementia. The original English version of the EdFED had three factors measuring: behavioral aspects of feeding difficulty (obstinacy/passivity); indicators of feeding difficulty; and nursing interventions. Methods: Participants affected by dementia and living in nursing homes (n = 210) were selected. Data collectors were trained to observe the residents' eating problems and their food intake. The data were analyzed using Mokken scaling and Pearson's correlation. Results: The Italian version of the EdFED Scale formed a Mokken scale which correlated in the expected direction with measures of residents' weight, Body Mass Index, time taken to eat, Mini Mental State Examination score and Barthel Index according to the unmet needs model of Cohen-Mansfield. Conclusions: The EdFED-I shows reasonable psychometric properties and can be used for the assessment of feeding difficulty in Italian samples of older people with dementia. However, further work with larger samples is required to test the utility of the whole range of items and the necessity of their inclusion in the EdFED-I

Novel human anti-claudin 1 mAbs inhibit hepatitis C virus infection and may synergize with anti-SRB1 mAb

Hepatitis C virus (HCV) is a major cause of chronic hepatitis and liver carcinoma and new therapies based on novel targets are needed. The tight junction protein claudin 1 (CLDN-1) is essential for HCV cell entry and spread, and anti-CLDN-1 rat and mouse mAbs are safe and effective in preventing and treating HCV infection in a human liver chimeric mouse model. To accelerate translation of these observations into a novel approach to treat HCV infection and disease in humans, we screened a phage display library of human single-chain antibody fragments by using a panel of CLDN-1-positive and -negative cell lines and identified phage specifically binding to CLDN-1. The 12 clones showing the highest levels of binding were converted into human IgG4. Some of these mAbs displayed low-nanomolar affinity, and inhibited infection of human hepatoma Huh7.5 cells by different HCV isolates in a dose-dependent manner. Cross-competition experiments identified six inhibitory mAbs that recognized distinct epitopes. Combination of the human anti-SRB1 mAb C-1671 with these anti-CLDN-1 mAbs could either increase or reduce inhibition of cell culture-derived HCV infection in vitro. These novel human anti-CLDN-1 mAbs are potentially useful to develop a new strategy for anti-HCV therapy and lend support to the combined use of antibodies targeting the HCV receptors CLDN-1 and SRB1, but indicate that care must be taken in selecting the proper combination

Dexmedetomidine: current role in burn ICU

Dexmedetomidine (DEX) is a relatively recent a2-adrenergic agonist which provides sedation, anxiolysis and analgesia with much less respiratory depression than other sedatives. These characteristics have implemented the use of the drug in the ICUs in order to achieve the target of a “arousable sedation”, thanks to its significant manageability. Its sedative-analgesic properties are also particularly suitable for use in burn ICUs, both adult and pediatric, which is why the current Guidelines have recognized a central role in the management of these categories of patients. Finally, DEX has showed significant anti-inflammatory effect both in animal models and in preliminary clinical trials, reducing vasopressor requirements and main mediators levels of the systemic inflammatory response involved in sepsis and similar processes, suggestingits use for improved outcome in ICU septic patients

Protocol for evaluating quality and safety for the public through home care nursing in Italy: a multicentre cross-sectional descriptive observational study (AIDOMUS-IT)

introduction: considering the increasing complexity of care and workload for home care nurses due to the ageing of the population, it is crucial to describe the work environment and the community care setting. the aim of this study protocol is to map the characteristics and identify gaps of home care in the community to design future interventions aimed at ensuring quality and safety. methods and analysis: this is a national cross-sectional descriptive observational study using the survey method. nurses from all participating community care centres will be recruited through convenience sampling by the coordinators of each centre, who will act as facilitators for this study. all community care recipients and their informal carers during the study period will be invited to complete a survey.to map the characteristics and identify gaps of home care in the community, three sources of data will be collected: (1) organisational characteristics, professional satisfaction, intention to leave and burn-out; (2) experience of care recipients and their informal carers and (3) improper access to the emergency department, readmission to hospital, comorbidities, services offered and users' level of autonomy, and main and secondary diagnoses.considering the total italian nursing population of approximately 450 000 registered nurses, a sample size of 1% of this population, equal to approximately 4600 nurses, was hypothesised.This study started in July 2022 and is planned to end in december 2023.data will be analysed using descriptive and inferential statistics. ethics and dissemination: this study protocol was approved by the liguria regional ethics committee in november 2022. informed consent will be obtained from participants and confidentiality will be ensured. data collected for this study will be kept anonymised in a protected database.the results of the study will be disseminated mainly through conferences, publications and meetings with government representatives

Experiences of older people following an acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study

Aims and objectivesTo explore the experience of patients affected by COPD following hospitalization due to an acute exacerbation event.BackgroundChronic Obstructive Pulmonary Disease (COPD) is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched – especially amongst people with COPD recovering from an acute event and facing a return home.DesignA descriptive phenomenological study.MethodsIn depth interviews were conducted with twelve COPD patients recently recovering from an acute exacerbation of their COPD. Data were analysed using Colaizzi's phenomenological framework.ResultsFour themes were identified from the data: a sense of loss and frustration, hopelessness, uncertainty about the future and fear of becoming a burden. Participants expressed quite negative views including a loss of hope, uncertainty about their future care and the burden they may become on their families. They appeared stressed and anxious as a result of the acute event they had experienced.ConclusionsThis study shows that an acute episode of illness can generate a sense of hopelessness and uncertainty about their future care in people with COPD. This occurs as they recover physically and think about the future, often in quite negative terms.Relevance to clinical practiceFor healthcare professionals it is important to take into account the potential feelings of loss, hopelessness and uncertainty that people can experience following an acute exacerbation of their COPD and ensure that psychological care is available as physical recovery takes place. Such care to include good discharge planning, giving patients time to express concerns and referral to counselling services if appropriate

Le savant et son époque à travers sa correspondance Seeger A. Bonebakker (1923-2005) et quelques notes sur Ḫalīl b. Aybak al-Ṣafadī (696-764/1297-1363)

This article proposes a survey of two great scholars’ in Arabic literature correspondences: a European of the 20th century, Seeger Adrianus Bonebakker, who is of special interest for us because he bequeathed all of his great library, personal notes and correspondence to Università Ca’ Foscari, and a subject of study of the former, Ḫalīl b. Aybak al-Ṣafadī, great littérateur and scholar of the first century of the Mamluk period. Letters sent and received are preserved in both cases and are primary sources on their network, but also on their personal life, personality and methodology