117,394 research outputs found
Il comfort dei pazienti sottoposti a chirurgia generale e vascolare
No full textObiettivi: Descrivere il grado di comfort dei pazienti nel pre e post intervento chirurgico; esplorare i bisogni dei pazienti sottoposti ad intervento chirurgico in anestesia generale, locale e locoregionale; individuare le strategie adottate dal personale infermieristico per ridurre il disagio determinato dal freddo nel post operatorio; verificare l’attenzione prestata dagli operatori al dolore nel post-operatorio e quali interventi sono stati messi in atto per ridurlo; esplorare la qualità percepita dal paziente riguardo l’informazione in vista della dimissione.Metodi. A 61 pazienti (campione di convenienza) è stato somministrato il “General Comfort Questionnaire” a 24 item di Kolcaba, autrice della “Comfort Theory”. La somministrazione è avvenuta solo nel periodo post intervento, prima della dimissione per evitare di sovraccaricare lo stato emotivo già compromesso. La rilevazione del comfort fa riferimento alla percezione soggettiva del paziente nella fase pre e post operatoria immediata. Sono state aggiunte alcune domande aperte per rilevare ulteriori bisogni e alcune variabili potenzialmente determinanti il grado di comfort (sesso, età, frequenza interventi). Risultati. La media del comfort percepita dal campione nel preoperatorio è pari a 127,27, quella nel post è di 134,32. che risulta più elevato ed è statisticamente significativo (p=0,0001). La differenza osservata nel pre tra i soggetti che eseguono l’anestesia generale e quelli che ricevono altri tipi di anestesia è statisticamente significativa (p=0,02). Non vi sono differenze statisticamente significative di grado medio di comfort in relazione al sesso, fasce d’età, frequenza degli eventi chirurgici, sia nel pre che nel post e in relazione alla somministrazione di antidolorifico (post). La maggior parte dei pazienti nella fase pre ha avvertito bisogni di informazione, comfort fisico, rispetto dei tempi e sostegno emotivo; 1/3 dei partecipanti ha accusato una sensazione di freddo nel post e la maggior parte dei pazienti ha ricevuto dagli operatori sanitari attenzione al dolore postoperatorio
The Hook Test Is More Accurate Than the Trampoline Test to Detect Foveal Tears of the Triangular Fibrocartilage Complex of the Wrist
No full textPurpose: To evaluate the accuracy of the trampoline and hook tests, used in the arthroscopic assessment of triangular fibrocartilage complex (TFCC) tears compared with arthroscopic direct visualization of the radiocarpal joint (RCJ) and of the distal radial ulnar joint (DRUJ). Methods: In total, 135 patients (97 male, 38 female, mean age 43.5 years) were divided into 2 groups: (1) 80 patients with chronic ulnar-sided wrist pain and positive fovea sign and (2) 55 patients with other complaints. TFCC was assessed by RCJ and DRUJ arthroscopy and by the trampoline and hook tests to detect rupture of distal and proximal components of the TFCC. Accuracy, specificity, sensitivity, and likelihood ratio of the 2 diagnostic methods were measured and compared, using RCJ and DRUJ arthroscopy as reference. Results: The trampoline and the hook tests showed an overall accuracy of 70.37% and 86.67%, respectively. The accuracy of the trampoline test was similar for distal (69%), proximal (66%), and complete (73%) TFCC tears. The hook test was more accurate when evaluating proximal (97%) and complete (98%) tears, rather than distal lesions (75%). Sensitivity for the trampoline and hook tests was 75.00% and 0.00% (P <.001) for distal tears and 78.85% and 100.00% (P <.001) and 58.33% and 100.00% (P <.001) for complete or isolated proximal tears, respectively. Specificity for the trampoline and hook tests was 67.27% and 96.36% (P <.001) respectively. Conclusions: The trampoline and hook tests can assure accurate diagnosis of peripheral TFCC tear. The hook test shows greater specificity and sensitivity to recognize foveal TFCC tears. Values of positive likelihood ratio suggest a greater probability to detect foveal laceration of peripheral TFCC for the hook test than for the trampoline test. These findings suggest that DRUJ arthroscopy is not necessary to confirm foveal incompetence of the TFCC, if the hook test is positive. Level of Evidence: Level II, retrospective diagnostic trial
COST-EFFECTIVENESS EVALUATION OF A CARE BUNDLE INTERVENTION FOR PREVENTING FALLS AMONG ITALIAN AGED INPATIENTS IN A STEPPED-WEDGE CLUSTER RANDOMIZED CONTROLLED TRIAL
No full textObjectives: Falls among hospitalized elderlies represent a frequent (20-30%) adverse event. About 30% of falls lead to injuries with different types of severity and can provoke long-time disability or death. The prevention of falls in the hospital is possible through the adoption of multimodal strategies. This study aimed at identifying the potential reduction in falls due to the Care Bundle implementation and its cost-effectiveness in real clinical environment Methods: 10 clusters (hospital units) of Bologna USL and University Hospital were randomized in a stepped-wedge design including 4 steps over the years 2015 and 2016. Incidence rates of falls in both the control and intervention periods were calculated considering the patientdays of exposure. The overall crude relative risk (RR) was calculated with its 95% confidence interval. The overall crude incremental cost-effectiveness ratio (ICER) per fall prevented has been calculated. The difference in the rate of patient falls during the intervention period compared with the control period was in the denominator of the ICER. The difference in intervention vs control costs (associated with implementation of the Care Bundle program, length of stay and hospital services provided to patients attributable to falls) was in the nominator. Results: A total of 11844 patients were randomized in this trial (intervention group n=6600, mean(SD) age=80.93(11.62); control group n=5244, mean(SD) age=78.14(12.68)) throughout the overall period. A 13% reduction (RR=0.87 (95% CI: 0.71-1.07)) in falls due to the Care Bundle intervention was observed, though it did not reach statistical significance. The overall ICER was €617.55 for fall prevented. Conclusions: The preliminary analyses showed a positive effect of Care Bundle intervention for preventing falls among aged inpatients at relatively low cost for fall prevented. Deeper statistical analyses to estimate precise cost-effectiveness of the Care Bundle intervention will be conducted shortly
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Postural control in childhood: Investigating the neurodevelopmental gradient hypothesis
No full textNeurodevelopmental disorders (NDDs) have been suggested to lie on a gradient con-tinuum, all resulting from common brain disturbances, but with different degrees of impairment severity. This case-control study aimed to assess postural stability against such hypothesis in 104 chil-dren/adolescents aged 5–17, of whom 81 had NDDs and 23 were healthy controls. Compared to healthy controls, Autism Spectrum Disorder (ASD) resulted in the most severely impaired neurode-velopmental condition, followed by Attention Deficit Hyperactive Disorder (ADHD) and Tourette Syndrome (TS). In particular, while ASD children/adolescents performed worse than healthy controls in a number of sensory conditions across all parameters, ADHD children/adolescents performed worse than healthy controls only in the sway area for the most complex sensory conditions, when their vision and somatosensory functions were both compromised, and performance in Tourette Syndrome (TS) was roughly indistinguishable from that of healthy controls. Finally, differences were also observed between clinical groups, with ASD children/adolescents, and to a much lesser extent ADHD children/adolescents, performing worse than TS children/adolescents, especially when sensory systems were not operationally accurate. Evidence from this study indicates that poor postural control may be a useful biomarker for risk assessment during neurodevelopment, in line with predictions from the gradient hypothesis
Square Dancing with the Stars to Enhance Dynamic Hirschman Linkages?
No full textIn this Presidential Address, the author takes the reader on a reconnaissance of his life and time as a regional scientist. He points out scenery he found scintillating along the way, hoping that some may pick up the banner and chew on a few of the ideas for a while. He suggests a revisit to Albert O. Hirschman’s notion of key sectors and more empirical analysis related to Marcus Berliant’s and Masahisa Fujita’s notion of knowledge creation and transfer.Presidential Address, San Antonio, Texas, March 29, 2014 (53rd Meetings of the Southern Regional Science Association
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Predictors of lung function decline: a retrospective study in COPD patients
No full textIntroduction: There is considerable controversy on the possible predictors of lung function decline in COPD. Aims: To evaluate wheter clinical and anthropometric characteristics and white blood cell count may be associated with the decline in FEV1 in COPD. Methods: We retrospectively selected 240 subjects referring to our outpatient clinic between 2010 and 2013 with a minimum follow-up of 34 months. We included in the study patients with baseline and follow-up information about: spirometric data, white blood cell count, anthropometric characteristics, smoking status, dyspnea (mMRC scale), chronic bronchits (cough and pleghm), history of AECOPD, treatment. Statistical analysis were performed by multivariate linear regression model, using FEV1% annual change as outcome, and age, sex, BMI, smoking status, eosinophils and neutrophils count, symptoms, AECOPDs and treatment as possible determinants. Results: A total of 70 patients were included (age 70,7±6,8yrs, 18 women, FEV1 1,56±0,68L/min, GOLD stage I, II, III+IV, 21, 32 and 17 pts respectively). Five subjects were active smokers. The BMI was 27,0±3,22 and the white blood cell count resulted normal in all subjects. The mean annual FEV1 decline was 0,014 L. In our model, eosinophil count (B 16.9; CI 0.94,32.8; p=0.039) and age were positively associated to FEV1 decline, i.e. the higher the eosinophil count and the age, the greater the functional decline. On the contrary, there was a negative association with BMI (B -0.34; CI -0.66,-0.022). p=0.037). Conclusions: Blood eosinophils, although in the normal range, are related to a faster decline in lung function. Moreover, a higher BMI may protect against FEV1 decline over the time
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