Quality of dying in hospital general wards: a cross-sectional study about the end-of-life care

Abstract Background In the last decade, access to national palliative care programs have improved, however a large proportion of patients continued to die in hospital, particularly within internal medicine wards. Objectives To describe treatments, symptoms and clinical management of adult patients at the end of their life and explore whether these differ according to expectation of death. Methods Single-centre cross-sectional study performed in the medical and surgical wards of a large tertiary-level university teaching hospital in the north of Italy. Data on nursing interventions and diagnostic procedure in proximity of death were collected after interviewing the nurse and the physician responsible for the patient. Relationship between nursing treatments delivered and patients’ characteristics, quality of dying and nurses’ expectation about death was summarized by means of multiple correspondence analysis (MCA). Results Few treatments were found statistically associated with expectation of death in the 187 patients included. In the last 48 h, routine (70.6%) and biomarkers (41.7%) blood tests were performed, at higher extent on patients whose death was not expected. Many symptoms classified as severe were reported when death was highly expected, except for agitation and respiratory fatigue which were reported when death was moderately expected. A high Norton score and absence of anti-bedsore mattress were associated with unexpected death and poor quality of dying, as summarized by MCA. Quality of dying was perceived as good by nurses when death was moderately and highly expected. Physicians rated more frequently than nurses the quality of dying as good or very good, respectively 78.6 and 57.8%, denoting a fair agreement between the two professionals (k = 0.24, P <  0.001). The palliative care consultant was requested for only two patients. Conclusion Staff in medical and surgical wards still deal inadequately with the needs of dying people. Presence of hospital-based specialist palliative care could lead to improvements in the patients’ quality of life

навчальний посібник

Психологія у професійній діяльності поліції : навч. посіб. / [О. О. Євдокімова, І. В. Жданова, Д. В. Швець та ін.] ; за заг. ред. В. В. Сокуренка; МВС України, Харків, нац. ун-т внутр. справ. - Харків, 2018. - 426 с.Навчальний посібник підготовлено відповідно до навчальних програм з дисциплін «Професійно-психологічна підготовка працівників поліції», «Юридична психологія», «Практична психологія». У посібнику висвітлено загальні та спеціальні психологічні питання професійної діяльності поліції. Рекомендується для використання в освітньому процесі підготовки поліцейських; у професійній діяльності працівників Національної поліції.The manual has been prepared in accordance with the curriculum for the disciplines "Professional psychological training of police officers", "Legal psychology", "Practical psychology". The manual covers general and special psychological issues of professional police work. Recommended for use in the educational process of training police officers; in the professional activities of employees of the National Police.Учебное пособие подготовлено в соответствии с учебными программами по дисциплинам «Профессионально-психологическая подготовка сотрудников полиции», «Юридическая психология», «Практическая психология». В пособии освещены общие и специальные психологические вопросы профессиональной деятельности полиции. Рекомендуется для использования в образовательном процессе подготовки полицейских; в профессиональной деятельности работников Национальной полиции

Caratterizzazione idrogeologica della piana di S.Eufemia (CZ) con l'ausilio di metodi termoconduttimetrici

Vengono riportati i primi risultati di uno studio realizzato con l’obiettivo di contribuire alla conoscenza delle caratteristiche idrogeologiche dell’acquifero che interessa la piana di S. Eufemia (CZ). La ricerca è stata svolta impiegando in particolare la temperatura dell’acqua sotterranea come indicatore della velocità di filtrazione e, conseguentemente, delle variazioni di permeabilità dei terreni costituenti l’acquifero. Pertanto lo studio è stato condotto affiancando alle tradizionali misure di livello freatimetrico, eseguite in 62 pozzi distribuiti in tutta l’area presa in considerazione, un congruo numero (38 pozzi investigati) di logs di temperatura e di conducibilità elettrica. In una prima fase di analisi delle misure sono stati interpretati i profili di temperatura e conducibilità elettrica. Il confronto di questi logs con una serie di sondaggi geognostici di riferimento ha permesso di formulare ragionevoli ipotesi integrative circa la natura biologica dei terreni interessati dalle perforazioni, nei quali sono stati precedentemente eseguiti i sondaggi. Successivamente dall’interpretazione dell’andamento delle isoterme su sezioni verticali e orizzontali, confrontate con l’andamento della superficie piezometrica è stato possibile avanzare alcune ipotesi integrative per definire in modo più dettagliato la struttura dell’acquifero considerato e le caratteristiche della circolazione idrica sotterranea

W.G. 4. AQUIFER ENGINEERING

The report of the COST ACTION 621 “Groundwater management in coastal karstic aquifers” is the result of the comparison and fusion of personal experiences of researchers coming from 15 european countries, which faced in their job many aspects both of the functioning and the managing of these karstic coastal aquifers. At the end of five years of meetings and visits held in towns and places of the 15 countries taking part to this COST ACTION 625, it has been written this report in the aim of fixing the work made and the experience carried on. On the other hand this report contains a very interesting and updated compilation of engineering methodologies adopted for groundwater exploitation in coastal karstic aquifer, and it presents many examples of catchment works, realized in european countries, of these methodologies. In particular this chapter 4 deals with different type of catchment works engineering. As a matter of fact in karst aquifers due to the general lack of surface water, groundwater exploitation is the only way to satisfy water demand, which is increasing in every coastal area, and usually surpasses the dynamic potential replenishment of the natural freshwater system. This fact causes a phenomenon named overexploitation, which is the origin of seawater intrusion. The engineering of catchment works in karstic coastal aquifers deals mainly about the problem of groundwater exploitation without starting seaweater intrusion and the consequent groundwater contamination