Organizzazione e Innovazione, dalle Aree Funzionali Omogenee al Modello di Intensità di Cure: “Il Nuovo Ospedale del Mare.”

La sfida della sostenibilità del Sistema Sanitario Nazionale sta inducendo le Aziende Sanitarie alla ricerca di soluzioni organizzative e gestionali per la riprogettazione dei processi produttivi e di supporto, con l’obiettivo di migliorare sia i livelli di efficienza e produttività, che quelli di appropriatezza e qualità delle prestazioni. A tale scopo, negli ultimi anni, si è registrato un interesse crescente per il Lean Management, anche nelle aziende sanitarie. La realizzazione del Nuovo Ospedale del Mare, nell’area metropolitana della città di Napoli; nato come modello innovativo di edilizia sanitaria, ad alto contenuto tecnologico e assistenziale, ha dato una forte spinta motivazionale affinchè nel presente lavoro, si declinasse un nuovo modello organizzativo che tenesse conto di presupposti innovativi quali il superamento delle aree funzionali omogenee incentrate esclusivamente sul sapere medico, ad aree organizzate per Intensità di cure. La peculiarità di questo modello organizzativo è la centralità della persona assistita e la multidisciplinarietà dell’equipe assistenziale

Mathematical models in nursing research

This paper discusses the use of advanced mathematical tools in nursing research, such as mathematical models used in medicine for description and prediction of experimental tumor growth. They are rarely used in nursing research, but fortunately in the last decade, their use is increased, particularly due to the artificial intelligence and Big Data, with great benefits for further development of nursing. Therefore, a strong interaction between nurses and mathematicians is needed to improve nursing research, and consequently the nurses performance in daily work

Clinical risk and patient safety: a multicenter cross-sectional study to explore knowledge, attitudes and practice of hospital nurses

Objectives: To investigate knowledge, attitudes, and behavior of nurses working in acute care hospitals regarding clinical risk and patient safety, and to identify predisposing factors. Design: Cross-sectional multicenter study. Methods: The study was conducted in thirteen non-teaching acute public and private hospitals of a region of southern Italy from September through December 2015. A structured self-report questionnaire was administered to clinical nurses working in the hospitals involved. Three multivariate linear and logistic regression models have been constructed: knowledge of the definition of an adverse event; attitude towards risk of making an error while working and nurses who reported at least one error in the past 12 months. Results: The sample consisted of 484 respondents out of 670 (72.2%) nurses approached. The final multivariable model showed that educational courses about patient safety play a significant role in nurses gaining knowledge of adverse events. In the absence of organization-wide patient safety programs, nurses with low knowledge levels showed a significantly higher perceived risk. Nurses (n=96) who made errors over the past 12 months had discussed them with head nurses (75%) and colleagues (41.7%). Anonymous reporting to the organization was very low, with only 8.3% of nurses who had made an error submitting an anonymous report. Conclusions: Managers should implement multimodal improvement strategies aimed at enabling nurses’ to recognize the critical issues of the system and to increase their reporting, in order to make the organizations safer

Continuity correction of Pearson’s chi-square test in 2x2 Contingency Tables: A mini-review on recent development

The Pearson’s chi-square test represents a nonparametric test more used in Biomedicine and Social Sciences, but it introduces an error for 2x2 contingency tables, when a discrete probability distribution is approximated with a continuous distribution. The first author to introduce the continuity correction of Pearson’s chi-square test has been Yates F. (1934). Unfortunately, Yates’s correction may tend to overcorrect of p-value, this can implicate an overly conservative result. Therefore many authors have introduced variants Pearson’s chi-square statistic, as alternative continuity correction to Yates’s correction. The goal of this paper is to describe the most recent continuity corrections, proposed for Pearson’s chi-square test

Evaluación de la Aclimatación y Rendimiento de 15 Cultivares de Arveja (Pisum sativum.) a campo abierto, en Macají, cantón Riobamba, provincia de Chimborazo

La presente investigación propone: Evaluar la aclimatación y rendimiento de 15 cultivares de arveja (Pisum sativum.) a campo abierto, en Macají, cantón Riobamba, provincia de Chimborazo. Para el diseño estadístico se utilizo el diseño de Bloques Completos al Azar (BCA) y tres repeticiones. El coeficiente de variación se expreso en porcentaje y se realizo la prueba de Tukey al 5%. Resultado que: El mayor porcentaje de prendimiento a los 4 días lo presento T14 (Liliana) con el 100 %. En la altura de planta T5 (Pure Line Seeds Legacy Verde) se mantuvo con la mejor altura hasta los 42 días alcanzando 24,35 cm, mientras que al día 56 la mayor altura así como mayor número de hojas lo presentó T7 con valores de 29,34 cm y 24 hojas respectivamente. El mayor número de tallos laterales y número de vainas por planta lo obtuvo T1 (Pure Line Seeds 183) con 18,67 y 52,67 respectivamente; El color de la flor fue blanco a excepción de T9 (Punto negro) el cual presentó una flor lila, mientras que el mayor número de semillas por vaina lo obtuvo T3 (Pure Line Seeds 105) con 10,67. Desde el punto de vista económico, se han determinado que el menor costo de producción fue T14 (Liliana) con 359.3USD, mientras que T13 (Televisión) presentó un mayor costo de producción con 835.4USD, en el beneficio neto se determinó que el tratamiento T15 (Utrillo) presentó mayor beneficio neto con 4684.06 USD. El tratamiento con mayor tasa de retorno marginal es T15 (Utrillo) con 1675.7%, lo que significa que por cada dólar invertido existe una tasa de retorno marginal de 16,76 USD

Nurses and Stigma at the Time of COVID-19: A Phenomenological Study

The COVID-19 pandemic is putting strain on every country in the world and their health systems. Healthcare professionals struggle on the frontline and they can experience stigma, which can create difficulties in controlling epidemic diseases, influencing the mental health of healthcare professionals, caregivers, families, communities, and the provided quality of care. The aim of this study is to explore the lived experience of Italian nurses about perceived stigma during COVID-19 pandemic with the phenomenological Cohen method. The principal themes that emerged from data analysis were “stigma in the working environment” and “stigma in everyday life”. Each of these themes had subthemes: “looks like gun sights”, “avoiding closeness to others”, “nobody wants to touch you”, and “the fault of being your family members”. Public health emergencies, such as the COVID-19 pandemic, are stressful events for individuals and communities. Stigma can be more dangerous than the disease, and a major obstacle to appropriate medical and mental health interventions. Understanding how healthcare professionals experience stigma is essential to design and implement specific educational, psychological, and organisational programmes

Helicobacter pylori and Epstein–Barr Virus Co-Infection in Gastric Disease: What Is the Correlation with p53 Mutation, Genes Methylation and Microsatellite Instability in a Cohort of Sicilian Population?

Genetic predisposition, environmental factors, and infectious agents interact in the development of gastric diseases. Helicobacter pylori (Hp) and Epstein–Barr virus (EBV) infection has recently been shown to be correlated with these diseases. A cross-sectional study was performed on 100 hospitalized Italian patients with and without gastric diseases. The patients were stratified into four groups. Significant methylation status differences among CDH1, DAPK, COX2, hMLH1 and CDKN2A were observed for coinfected (Hp-EBV group) patients; particularly, a significant presence of COX2 (p = 0.0179) was observed. For microsatellite instability, minor stability was described in the Hp-HBV group (69.23%, p = 0.0456). Finally, for p53 mutation in the EBV group, exon 6 was, significantly, most frequent in comparison to others (p = 0.0124), and in the Hp-EBV group exon 8 was, significantly, most frequent in comparison to others (p < 0.0001). A significant positive relationship was found between patients with infection (Hp, EBV or both) and p53 mutation (rho = 0.383, p = 0.0001), methylation status (rho = 0.432, p < 0.0001) and microsatellite instability (rho = 0.285, p = 0.004). Finally, we observed among infection and methylation status, microsatellite instability, and p53 mutation a significant positive relationship only between infection and methylation status (OR = 3.78, p = 0.0075) and infection and p53 mutation (OR = 6.21, p = 0.0082). According to our analysis, gastric disease in the Sicilian population has different pathways depending on the presence of various factors, including infectious agents such as Hp and EBV and genetic factors of the subject

Functional properties of Lactobacillus plantarum strains: A multivariate screening study

Abstract Thirty-two Lactobacillus plantarum strains isolated from different sources were genetically characterized at subspecies level with recA gene based multiplex PCR and pulsed-field electrophoresis. All the strains were tested in vitro for functional properties (ability to form biofilms, agglutination of yeast cells, bile salt hydrolase activity, β-galactosidase activity, surface hydrophobicity, resistance to lysozyme, gastric juice and bile salts), for antimicrobial activity and for antibiotic resistance. The presence of bsh and msa genes and of the pln bacteriocin loci were also evaluated. Hierarchical cluster analysis was used to identify eight different plantaritypes sharing similar patterns of pln loci. A global functional score was calculated by transforming values for continuous in vitro functional properties in an ordinal scale by cluster analysis, while a nominal scale was used for the other properties. Multidimensional scaling was used to evaluate the similarity in functional properties among the isolates and to evaluate the relationships between source of isolation and functional properties. Nine strains showed the best in vitro functional potential and a significant relationship was found between source of isolation and functional score. This study confirmed a high heterogeneity in functional properties among L. plantarum strains and provides insight for optimal screening strategies

Nurses in Public Health: A profession in continuous evolution

Today, nurses play a fundamental role in Public Health. In the last few decades the health profession has seen strong professional growth, in the areas of Clinical practice, Management and Education. In particular, this growth has been also informed by the progress being made in nursing research. In fact, nursing research has contributed to the establishment of support tools to facilitate and evaluate the daily work done by nurses, contributing significantly to the improvement of their professional performance