775 research outputs found
High concordance between trained nurses and gastroenterologists in evaluating recordings of small bowel video capsule endoscopy (VCE)
Background & Aims: The video capsule endoscopy (VCE) is an accurate and validated tool to investigate the entire small bowel mucosa, but VCE recordings interpretation by the gastroenterologist is time-consuming. A pre-reading of VCE recordings by an expert nurse could be accurate and cost saving. We assessed the concordance between nurses and gastroenterologists in detecting lesions on VCE examinations. Methods: This was a prospective study enrolling consecutive patients who had undergone VCE in clinical practice. Two trained nurses and two expert gastroenterologists participated in the study. At VCE pre-reading the nurses selected any abnormalities, saved them as âthumbnailsâ and classified the detected lesions as a vascular abnormality, ulcerative lesion, polyp, tumor mass, and unclassified lesion. Then, the gastroenterologist evaluated and interpreted the selected lesions and, successively, reviewed the entire video for potential missed lesions. The time for VCE evaluation was recorded. Results: A total of 95 VCE procedures performed on consecutive patients (M/F: 47/48; mean age: 63 ± 12 years, range: 27â86 years) were evaluated. Overall, the nurses detected at least one lesion in 54 (56.8%) patients. There was total agreement between nurses and gastroenterologists, no missing lesions being discovered at a second look of the entire VCE recording by the physician. The pre-reading procedure by nurse allowed a time reduction of medical evaluation from 49 (33-69) to 10 (8-16) minutes (difference:-79.6%). Conclusions: Our data suggest that trained nurses can accurately identify and select relevant lesions in thumbnails that subsequently were faster reviewed by the gastroenterologist for a final diagnosis. This could significantly reduce the cost of VCE procedure
Gli interventi educativi per i pazienti con scompenso cardiaco: una sintesi della letteratura
Patient education is recognized as a central component of heart failure care and reduces hospital readmissions. Nurses have an important role in providing patient education and modifying self-care behaviors. The aim of this article is to examine characteristics of educational interventions for heart failure patients, their measured outcomes and the role of nurses in providing education. We conducted a literature review of the last 10 years and considered 30 articles. Multisession motivational interventions, repeated over time and with different follow-up interventions seem to produce the best results. However, some aspects remain controversial
Validity and reliability of the Italian version of the Oral Assessment Guide
Mucositis is a frequent side-effect of chemotherapy and radiotherapy. Assessment of oral cavity is important to
detect alterations in the mouth and plan appropriate interventions. A reliable tool can help to have a better assessment
of mucositis and a major knowledge about this phenomenon. Since no valid and reliable tool for the assessment
of mucositis is still available in Italy, the aim of this study was to establish the validity and reliability of the
Italian version of the Oral Assessment Guide (OAG). A panel of health care experts established the content validity
of the tool both for the items and the descriptors. To establish the reliability of the tool, a sample of 14 inpatients
with haematological diseases were recruited. Couples of dental hygienists separately performed 60 pairs of
assessments (for a total of 120 assessments) on the sample. The Italian version of OAG was found to have an acceptable
Content Validity Index (CVI) for items and related descriptors ranging between 0.67 and 1. Cronbachâs alpha
was 0.84, agreement of assessment ranged between 0.87 and 0.65 with Cohenâs Kappa coefficient ranging from
good to very good. This study showed that the Italian version of the OAG has good psychometric properties of
validity and reliability to assess mucositis in patients undergoing chemotherapy. This tool will have a great importance
to carry out future research in Italy aimed to improve the patient's outcomes particularly in terms of functional
ability and quality of life
Nursing student attitudes towards older people: validity and reliability of the Italian version of the Kogan Attitudes towards Older People scale
Aim. This paper reports a study testing the validity and reliability of the Italian version of the Kogan Attitude towards Older People scale.
Background. Nursing studentsâ attitudes towards older people can affect their
preference for working with them. One of the most common instruments used to
assess these attitudes is the Kogan Attitude towards Older People scale. Previous validation studies performed on college students internationally have demonstrated good reliability and validity. The psychometric properties of the Italian version have not yet been tested.
Design. A cross-sectional, descriptive study.
Method. The study was conducted from MarchâJune 2010 with a convenience
sample of nursing students attending two Italian universities. Reliability was evaluated using internal consistency and item-to-total correlation. Content and construct
validity were evaluated using a content validity index and principal factor
analysis.
Results. A total of 1637 nursing students participated in the study. Two factors were extracted from the factor analysis: prejudice describing a negative disposition and appreciation indicating a favourable feeling and opinion towards older people.
Conclusion. The Kogan Attitude towards Older People scale applied to Italian
nursing students exhibited good internal consistency. The two-dimensional construct of the scale was congruent with some, but not all, results of previous studies due to methodological differences among the studies. Based on the study findings,
the scale can be recommended for future research studies in Italy including use as pre/post-test measurement associated with nursing education programmes
Lavagnone (Desenzano del Garda) : new excavations and palaeoecology of a Bronze Age pile dwelling in northern Italy
Lavagnone is a lacustrine basin, today turned into a peat bog, which was continuously settled for about 1,000 years during the Early, Middle and Late Bronze Ages. Since 1991 research has been carried out under the supervision of R. C. de Marinis (Universit\ue0 degli Studi di Milano) in four different areas of the basin in order to reconstruct the features of the settlement and the changes that occurred over the course of time. Palynological and palaeobotanical analyses, taking place since 2002 in cooperation with CNR-IDPA (Milano), are focused on determining the palaeoenvironmental manifestation, both then and now, of the anthropogenic exploitation of the basin
Continuity of Care During End of Life: An Evolutionary Concept Analysis
PURPOSE: The purpose of this study was to clarify the concept of continuity of
care during the end of life with a focus on the patientâs perspective.
METHODS: Rodgersâ method of evolutionary concept analysis was used. The
analysis was based on literature published in English in the databases Cumulative
Index for Nursing and Allied Health Literature, Medline, and PsycINFO.
FINDINGS: Analysis revealed that the continuity at lifeâs end is a dynamic process
that depends on the interaction among patients, families, and providers, and is
strictly interwoven with the patientâs time perception.
CONCLUSION: This analysis showed the complexities surrounding the patientâs
experience of continuity at lifeâs end.
IMPLICATION FOR NURSING: Nurses can benefit from a deeper understanding
of the patientâs experience, both theoretically and in practice
Climate and land-use change during the late Holocene at Lake Ledro (southern Alps, Italy)
International audienceThis paper investigates the relative influences of climatic and anthropogenic factors in explaining environmental and societal changes in the southern Alps, Italy. We investigate a deep sediment core (LL081) from Lake Ledro (652 m a.s.l.). Environmental changes are reconstructed through multiproxy analysis, that is, pollen-based vegetation and climate reconstruction, magnetic susceptibility (MS), lake level, and flood frequency, and the paper focuses on the climate and land-use changes which occurred during the late Holocene. For this time interval, Lake Ledro records high mean water table, increasing amount of pollen-based precipitation, and more erosive conditions. Therefore, while a more humid late Holocene in the southern Alps has the potential to reinforce the forest presence, pollen evidence suggests that anthropogenic activities changed the impact of this regional scenario. Land-use activity (forest clearance for pastoralism, farming, and arboriculture) opened up the large vegetated slopes in the catchment of Lake Ledro, which in turn magnified the erosion related to the change in the precipitation pattern. The record of an almost continuous human occupation for the last 4100 cal. BP is divided into several land-use phases. On the one hand, forest redevelopments on abandoned or less cultivated areas appear to be climatically induced as they occurred in relation with well-known events such as the 2.8-kyr cold event and the âLittle Ice Ageâ. On the other hand, climatically independent changes in land use or habitat modes are observed, such as the late-Bronze-Age lake-dwellings abandonment, the human population migration at c. 1600 cal. BP, and the period of the Black Death and famines at 600 cal. BP
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