1,354,289 research outputs found
Il difficile dell’imprevedibile
No full textNel tempo della pandemia abbiamo subito la violenza della realtà sul mondo umano. Si tratta di una violenza che ha annientato molte vite e ha interrotto la continuità della vita ordinaria. Di fronte a questo accadere i servizi sanitari hanno dovuto affrontare in uno stato di emergenza un significativo riassetto organizzativo, sostenere un impegno di lavoro considerevole, ideare nuovi modi di pensare la cura. La fatica, fisica e mentale, degli operatori è stata molta. Per affrontare la pandemia sono stati inventati nuovi saperi e nuovi dispositivi di cura, è stato sperimentato il valore e i limiti delle politiche che erano in atto e hanno preso forma nuovi saperi esperienziali. Una parte di questi saperi resta, o perché si è materializzato in dispositivi tecnologici o perché ha trovato forma in linee guida, ma una parte di quello che è stato elaborato rischia di non essere conservato. Questa ricerca nasce con l'intenzione di raccogliere i pensieri di coloro che hanno sostenuto questa grande fatica e cercare parole che consentano di conservare ciò di cui è stata fatta esperienza
L'utilizzo di prodotti a base di colostro nella prevenzione e trattamento della mucosite orale nei pazienti onco-ematologici
No full textE’ stato condotto uno studio osservazionale per conoscere il fenomeno della mucosite nel contesto locale, implementare il protocollo di igiene orale e l’intervento educativo da parte dell’infermiere.
E’ stata inoltre condotta una revisione sistematica della letteratura per descrivere le prove a supporto dell’utilizzo del colostro nell’ambito della salute e della malattia. La ricerca è stata condotta all'interno dei seguenti database: Medline, Embase, Cochrane Library e Cinahl. La valutazione della qualità metodologica degli studi inclusi è stata effettuata con due strumenti validati, l’EPHPP e l’AMSTAR-2 e il livello di evidenza con il metodo OCEBM del 2011 dell'Oxford Center for Evidence-Based Medicine [18] da due revisori indipendenti.
Lo studio di Fase II sui pazienti sottoposti a TCSE è stato progettato secondo il modello di Simon in due step per garantire la sicurezza dei pazienti ed evitare la futilità dello studio. I prodotti a base di colostro e di aloe, un collutorio e una gastropasta da deglutire, sono stati aggiunti alla pratica standard di igiene del cavo orale (IG) 3 volte al giorno come prevenzione dall’inizio del condizionamento, e 5 volte al giorno come trattamento dopo la comparsa della OM. Oltre ai dati socio-demografici, sono stati raccolti dati su prevalenza e severità della OM, sulla sicurezza dei prodotti e l’aderenza ai prodotti e al protocollo di igiene orale fino a 21 giorni dopo il trapianto. L’endpoint primario è rappresentato dall’incidenza della mucosite severa (3-4 WHO). Gli endpoints secondari sono l’incidenza della mucosite (di ogni grado), la durata e i tempi d’insorgenza, il grado del dolore, della deglutizione, della fonazione e salivazione. Ipotizzando una riduzione della prevalenza di mucosite severa del 50% (dal 30% al 15%), il campione previsto era di 59 pazienti. Grande attenzione è stata posta anche all’esperienza soggettiva dei pazienti attraverso l’utilizzo dell’OMDQ e dell’European Quality of Life Utility Scale (EQ-5).
L’ultimo step è rappresentato dalla progettazione di un RCT multicentrico in doppio cieco con placebo
Taste and watch for an aware food consumption in the school
No full textMonitor school meals and students’ appreciation, promoting
awareness about food use/waste, in relationship with breakfast and morning snacks.
Determine approval rating, and measure food waste in school, to develop strategies for management and education about prevention and reduction of food waste.
Methods
To control the food waste in school, it was developed a collaboration between healthcare (SIAN, Bologna’s USLgency), education (school) and society (parents, scholastic foodservice and administration).
Two surveys were prepared about the appreciation and consumption of provided meals, breakfast and morning snacks, and a hundred 3rd and 4th grade children participated. Bread and fruit leftovers were used as snacks or given to charity.
Each phase of the project was video taped to show participation of all parties. The results were discussed with all the participants while planning for following school years.
Results
2069 nutritional profiles were examined (breakfast, snack, and lunch). The consumption of first (pasta) and second (meat or fish) courses was 3/4, while vegetables, breads, and fruits, was 1/2. Those who had a proper breakfast and/or morning snack tended to eat a greater quantity of food for lunch.
Some differences emerged between the two schools involved. In one school there was significantly higher meal consumption, with a two-fold difference for vegetables, second dishes and fruits. The difference between schools with equal socio- economic status, seemed to be due to the active and authoritative teachers.
Conclusions
The surveys were simple and well accepted by the children. They actively participated with enthusiasm, and they were awarded with the title of ‘‘little tasters’’.
The joint planning between the education, healthcare, and social components will continue: it will start a project for all the schools of Bologna to promote the consumption of proper snacks (fruits), and to monitor food waste, in order to guide both nutritional education interventions.
Key messages:
Scholastic food service is a very important occasion to promote nutritional education and an healthy diet.
To succeed, is fundamental the active involvement of children, teachers, parents, scholastic foodservice and healthcare, to balance between offering healthy food and maximizing customer satisfaction
Ro5-4200 in bronchoscopy
No full textA simple technique employing i.v. Ro5-4200 and a local anaesthetic to obtain general anaesthesia prior to bronchoscopy, particularly after chest operations, is described. The optimal sedation offered by Ro5-4200 enables this trying examination to be performed without risk and with the best possible degree of comfort for the patient and the operator
Il contributo delle Reti Tematiche SOCRATES al mutuo riconoscimento e accreditamento Europeo dei titoli di studio in ingegneria
No full textModels of parasite biocoenosis dynamic: host density and gastrointestinal parasites in alpine chamois
No full textHost density is an important and widely accepted factor influencing microparasites epidemiology.
In theory, host density would influence also macroparasite dynamic, although it would be achieved indirectly due to the presence of free-living infective stages of parasites. On this basis, it is expected that macroparasite abundance and prevalence would increase as host density increases, due to the higher probability for a new host to acquire infections from the environment. Nevertheless, some surveys indicate a negative relationship between host density and gastrointestinal helminth abundance in alpine chamois. On the basis of data collected from three different chamois populations, the Authors discuss the possibility that ecological factors different from host density should influence parasite biocoenosis dynamic, leading to the pattern observed in natural chamois-parasite systems
Surveillance, monitoring and survey of wildlife diseases: a public health and conservation approach
No full textDuring the past decades the interest in surveillance and monitoring of wildlife diseases has grown internationally. The main reasons could be the following: a) increased size of many wildlife populations that host pathogens affecting humans; b) the increased economic relevance of some wildlife disease; c) the role played by infections/diseases in the conservation of some wild endangered species. According to the above-described epidemiological situations there is an international need to develop appropriate strategies for the early detection, monitoring and surveys of infectious diseases in wildlife. The paper reviews the epidemiological assumptions on which disease surveillance, monitoring and surveys are, or should be, based. The main conclusions are: 1) wildlife disease surveillance and monitoring are long lasting activities that should be implemented when legal bases are available; 2) a wildlife disease introduced in a free area is more likely to be detected early using passive rather than active surveillance; 3) the definition of the "suspect case" largely affects the sensitivity of the whole passive surveillance; thus the suspected case definition should be modulated according to the level of risk; 4) in both active surveillance and monitoring, sampling plays an important role. The sensitivity of any active surveillance/monitoring system is highly dependent from the sampling unit that we define as: "the host target subpopulation, whose size can maintain the pathogen during a defined inter-sampling interval". Such definition merges the ecological, epidemiological and mathematical approaches aimed in controlling or eradicating infections in both livestock and wildlife; 5) When dealing with the conservation-disease interface, a standardized risk assessment procedure including risk mitigation has to become the rule
Epidemiologia delle virosi respiratorie nel capriolo in provincia di Bologna
No full textA seroepidemiological survey has been carried out in roe deer and sympatric cattle in the Bologna Province. The following prevalences has been found: 52% to PI-3 Virus and 6% to BRSV in roe deer and of 67% and 54%, respectively, in cattle. Comparative analyses show that PI-3 Virushits indifferently both host species, with possible reciprocal transmission between them. Cattle seem to repreent the reservoir of BRSV, with sporadic infection in roe deer population. Antibodies to IBR Virus have not been found n roe dee
Gastro-intestinal helminths in chamois (Rupicapra rupicapra) in the Dolomites, Italy
No full textFrom November to December 1994, 54 chamois hunted in a small area of the Dolomites were examined for gastro-intestinal parasites Prevalences and intensities of the species found are reported. The parasite burden decreased with age, no differences associated with sex were found. The parasite species with a prevalence > 2% fit a negative binomial distribution, but the degree of aggregation decreased progressively with age, so that in the younger class (6-12 months) most of the parasite species fit a poisson distribution
A nurse-led multidisciplinary service for Nipple-Areola complex tattooing after breast cancer: reporting on a complex intervention with TIDieR analysis
No full textBackground: The Nipple-Areola Complex (NAC) tattooing can restore physical and mental integrity after breast cancer, but it is not always easily accessible for women. This paper aims to report on the development of a multidisciplinary nurse-led service for NAC tattooing for women who underwent breast cancer surgery with NAC removal to allow its thorough review and replication. Methods: The Medical Research Council’s framework for developing complex healthcare interventions was followed. According to the results of a literature review, and the context analysis, an initial intervention was planned. The Template for Intervention Description and Replication checklist was chosen to ensure the quality and completeness of the intervention description. Results: The Breast Unit and the Research departments were engaged; three nurse-tattooists were selected; the informative material was created and shared with patients, families and local associations, involving them actively. Finally, the setting and the materials were defined. A monthly schedule of activities was set: patients with the indication for NAC tattooing were contacted by the nurse case manager. Each treatment involves 3–4 sessions, 30–40 days apart, in an ambulatory setting. It consists of NAC shaping and tattooing with a dermographer and sterile needles. Conclusion: Implementing freely and equally multidisciplinary nurse-led clinics might provide this treatment ensuring the patient’s quality of life and nurse competence. The NAC tattooing is a complex intervention that represents the final part of the breast cancer surgical care pathway
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