1,720,967 research outputs found
Anticholinergic burden before and after hospitalization in older adults with dementia: Increase due to antipsychotic medications
No full textOBJECTIVES:
To evaluate changes in the use of antipsychotics and medications with anticholinergic activity (MACs) during hospitalization in older adults with dementia and factors associated with antipsychotic prescriptions and increased anticholinergic burden (ACB).
METHODS AND DESIGN:
This retrospective cohort study included all patients aged 65 years or older with a discharge diagnosis of dementia hospitalized at the university hospital of Udine, Italy, from 2012 to 2014. Medications dispensed within 3 months before and after hospitalization were identified in community-pharmacy dispensations while those prescribed at discharge were collected from Hospital Electronic Medical Records (EMR). ACB was assessed using the Anticholinergic Cognitive Burden score.
RESULTS:
Among 1908 patients included, at discharge, 37.0% used one or more antipsychotic (9.4% before and 12.6% after hospitalization), 68.6% used one or more MAC (49.1% and 45.7%, respectively), and ACB of 38.4% of patients increased at discharge mainly because of a higher use of antipsychotics with anticholinergic activity (33% at discharge vs 12% before hospitalization). Prescription of antipsychotics at discharge was associated with prior treatment with antipsychotics (adjusted odds ratio [aOR] 4.85; 95%CI, 3.37-6.97), psychiatric conditions, (4.39; 3.47-5.54) and discharge from surgical department (2.17; 1.32-3.55). An increased ACB was associated with psychiatric conditions (1.91; 1.52-2.39), discharge from surgical (1.75; 1.09-2.80) or medical department (1.50; 1.04-2.17), and with cardiac insufficiency (1.41; 1.00-1.99).
CONCLUSIONS:
ACB was higher at discharge, and antipsychotics were the main drivers of this increase. Clinicians treating older adults with dementia should be aware of the risks associated with antipsychotics and that some of these medications may increase the risk of anticholinergic effects
Monitoring compliance with hospital guidelines for perioperative antimicrobial prophylaxis (July 2013 – December 2016)
No full textCompliance all’antibioticoprofilassi peri-operatoria in un’Azienda Sanitaria Universitaria Integrata: risultati di un monitoraggio triennale
No full textINTRODUZIONE L’antibioticoprofilassi peri-operatoria è una pratica di fondamentale importanza per prevenire l’infezione del sito chirurgico. L’Azienda Sanitaria Universitaria Integrata di Udine ne ha definito le caratteristiche in una procedura specifica, diffusa a tutte le strutture e disponibile nell’Intranet aziendale. È stata monitorata su base semestrale la compliance alla procedura a partire dall’ultimo aggiornamento occorso (30 giugno 2013). METODI Tra luglio 2013 e giugno 2016 sono state analizzate 1440 cartelle cliniche (15 per semestre per i 16 reparti chirurgici) estratte casualmente includendo ricoveri ordinari con intervento chirurgico pulito o pulito/contaminato. La procedura è stata valutata compliante al protocollo se aderiva alle linee guida per tutti gli item considerati: tipo di molecola, dosaggio, timing di somministrazione, redosing e durata della profilassi. Il confronto tra proporzioni è stato effettuato tramite il test Chi-Quadrato. L’analisi del trend è stata condotta attraverso il Cochran-Armitage Trend Test. RISULTATI La tabella 1 riassume i dati della compliance complessiva e specifica per singolo item. Si evidenzia un aumento significativo della compliance complessiva tra 2° semestre 2013 e 1° semestre 2016 (+9%, p=0,048); il trend di tale aumento si è rivelato lineare (p=0,007). Si registra, nello stesso intervallo di tempo, un aumento significativo della compliance relativa al tipo di molecola utilizzato (+7%, p=0,044) e alla durata della profilassi (+10%, p=0,003). CONCLUSIONI La compliance alla procedura aziendale è migliorata nel tempo. Il monitoraggio semestrale è stato essenziale per valutare lo stato dell’arte, individuare tempestivamente le situazioni su cui intervenire e orientare azioni di miglioramento in caso di riduzione dei valori di compliance (i.e. incontri con le singole strutture, ulteriori strategie di diffusione della procedura)
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Sexual health and contraception. A three years survey on Italian students’ knowledge and behaviours
No full textBackground
Sexual health and experiences are considered of utmost importance for their influence on adolescents’ personal and intellectual development.Sexually transmitted diseases(STDs) and undesired pregnancies represent one of the greatest problems impacting adolescents all over the world. The aim of the study was to assess knowledge and behaviours of adolescents regarding contraception and STDs.
Methods
From 2014 to 2016 a self-designed questionnaire had been given to students of five different high schools of Udine(North-East of Italy) attending the first or the second or the third year. The questionnaire was composed by 5 open- and 10 closed-ended queries (maximum score of 19 points), regarding knowledge and attitudes related to contraception and STDs infection and prevention.
Results
Questionnaires were completely filled in by 3076 students: 46% males, 53%females and 1% n.d. Comparing global results on students knowledge among the years, right answers median scores showed little variations with a decrease between 2014 and 2015 (8/19 in 2014, 7/19 in 2015 and 7/19 in 2016). Identify correctly a threshold age for family counselling and the population with the highest risk for new HIV infections were the most critical topics (only the 3% and the 15% of the students gave the right answer respectively). Regarding behaviours, from 2014 to 2016 students declared to be more self-confident in refusing to have unprotected sex (+22%, p < 0,05). Furthermore they pinpointed parents(19%), hospital doctors(18%) and chemists(12%) as the main figures they would ask for contraception advices.
Conclusions
Results showed constant levels of knowledge on sexual health topics in the years. Self-confidence in preventing measures is increasing, however adolescents seem poorly educated about access to services and relevant epidemiology data on STDs infection. This survey could be a starting point for the implementation of more focused educational interventions.
Key messages:
Adolescents' knowledge on sexual health is constant during the years, with specific lacks in education.
Parents and healthcare professionals are the main figures receiving requests by adolescents concerning sexual health and contraception advices
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe 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
Sexual health knowledge and its promotion in adolescents: three years of interventions in Udine
No full textBackground
The WHO defines sexual health as a state of comprehensive well-being in relation to sexuality and education is essential for reducing inequality and addressing needs of vulnerable groups. The Italian educational system overlooks sexual education, so no baseline information levels have been defined. The purpose of this study is to evaluate the efficacy of a sexual health educational project in five heterogeneous high schools of Udine (North-Eastern Italy) as a part of the WHO Healthy Cities project.
Methods
The intervention took place between 2014 and 2016 involving a multidisciplinary team (psychologists, doctors and others). Students with minimum age of 14 were given six hours of lectures in three subsequent weeks, regarding psychological, bio-anatomical and infection prevention subjects respectively.
To test the efficacy of the intervention, a self-designed questionnaire had been administered to participants both before and after the cycle. The focus of 11 questions was on STDs and contraception (maximum score: 19 points). Medians of scores were calculated and compared using the Wilcoxon-Mann-Whitney test.
Results
Total questionnaires were 6033 (46% males, 52% females and 2% not declared). Educational paths of students were not equally represented (scientific 15%, technical 34%, social sciences 21%, arts 13%, commerce 17%). Comparing medians of pre- and post-intervention scores, they increased globally by year (+37.5% in 2014, +57.1% in 2015, +57.1% in 2016, p < 0.001 for all). They increased in each school as well by year, ranging from +25% (technical school in 2016) to + 71.2% (scientific and commerce schools in 2016), with p < 0.001 for all.
Conclusions
The results show a widespread increase in knowledge after this intervention, suggesting the efficacy of a multi-professional sexual health promotion project. Further analyses could evaluate specific subjects or schools in detail, helping to redesign and fine-tune the project according to educational needs.
Key messages:
Sexual education and sexual health promotion show their efficacy on a broad audience when a multidisciplinary team is involved.
Monitoring knowledge about sexual health themes in different contexts can help to tailor an appropriate intervention
Parental thoughts after the Codroipo case: the other side of the story
No full textBackground: To address vaccine hesitancy and to build public trust, many factors need to be considered in the process of planning consistent public health interventions. After uncertain vaccinations of the Codroipo case, hesitant parents were surveyed about own beliefs and trusted sources of information. Methods: A semi-structured phone survey was conducted between December 2017 and February 2018, collecting also age and educational level of respondents. Results: The most trusted sources of information of the 258 surveyed parents were pediatricians (27.2%), general practitioners (25.4%) and institutional channels (12.1%). Highly educated parents trusted self-study of the scientific literature and expressed doubts about vaccine effectiveness more than others (p=0.0018). Conclusion: Despite the underlying improper vaccination issue undermined public trust, healthcare professionals and institutional channels maintained their role as trusted sources of information. Educational patterns emerged among doubtful parents should be considered by public health policies to effectively tackle vaccine hesitancy
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