1,720,958 research outputs found
Migliorare l’appropriatezza clinico-organizzativa attraverso la creazione di un ambulatorio di isteroscopia office
No full textProgetto di riorganizzazione di un pronto soccorso ospedaliero
No full textParallelamente al processo di dipartimentalizzazione aziendale
ha avuto luogo, all’interno del Dipartimento di Emergenza-Urgenza
della Usl 7, il progetto di miglioramento del Pronto Soccorso dello
Stabilimento Ospedaliero di Nottola. Il piano di lavoro si è sviluppato
su livelli apparentemente separati fra loro, ma comunicanti
allo stesso tempo, infatti i cambiamenti strutturali sottintendono
sempre un cambiamento nell’operatività del personale. I primi risultati
ottenuti sembrano confortare il progetto migliorativo intrapreso,
anche grazie al processo di integrazione professionale tra personale
medico ed infermieristico del Pronto Soccorso e dell’emergenza
territoriale (118)
An integrated territory-hospital approach to diabetes care
No full textBackground
Diabetes mellitus is a chronic illness that requires constant medical care including patient education and empowerment. Local Health Authorities (LHA)-7 of Siena (south of Tuscany Region) adopted MITO.SI, an informatics interaction and exchange of patient data between General Practitioner and Hospital Specialists to realize an integrated management of Chronic Care Model (CCM) paths. The aim of this study is to assess, from MITO.SI database, if this new organizational structure (CCM + MITO.SI) has achieved, in our LHA, the regional standards of efficacy and efficiency (by monitoring some indicators of professional appropriateness and quality).
Methods
The LHA-7 has 254 General Practitioners, of which 130 have joined the project MITO.SI (51,1%), about 126.000 patients (54,3%). We did a descriptive analysis through percentages or rates recorded at Tuscany Region/LHA level for each indicator. Than we used measures of Risk Ratio (RR) to verify if there were any statistically significant Tuscany/LHA differences.
Results
In the comparison (year 2011) between LHA-7 and Tuscany region, we observed: the hospitalization rate (per 100.000) was 26,58 (+6.69 from Tuscany), RR 1,29 (p < 0.05, CI:0,96–1,71); the percentage of patient with a year measurement of glycated haemoglobin was 64,8% (-3.9% from Tuscany), RR 0,82 (p < 0.01, CI:0,79-0,85); the percentage of patient with a screening test for diabetic retinopathy was 33,4% (+1.3% from Tuscany), RR 1,04 (p < 0.01, CI:1-1,08); the percentage of patients adherent to statin therapy was 40,01% (-2,17% from Tuscany), RR 0,93 (p < 0.01, CI:0,90-0,96); finally among the patients who use this drug, the percentage of statin not covered by patent was 52,65% (-0,01% from Tuscany), RR 0,99 (p < 0.01, CI:0,98-1)
Conclusions
The management of chronic diseases has shifted progressively from the hospital to the community care. To create a database containing all the information related to diabetes patients may allow the organization and management of educational activities and the integration between the various professionals involved
Non-fatal Road Traffic Injuries: Can Road Safety Campaigns Prevent Hazardous Behaviour? An Italian Experience
No full textOBJECTIVES:
Road traffic injuries are a widespread problem and are very difficult to prevent. The purpose of this study was to verify whether intensive versus basic road safety education programs are associated with different incidence and severity of nonfatal road injuries.
METHOD:
The study had an ecological design and involved Local Health Authority One (LHA1) in Salerno, Italy, which includes 20 municipalities. Data on nonfatal road injuries occurring in the periods June to August 2003 and June to August 2008 were obtained from trained operators through the information system of the emergency department. All 20 municipalities received a basic community road safety education program (publicity campaign using bill-posting, brochures, mass media communication with press conferences, articles in local papers, radio and television interviews, and a dedicated LHA1 web site), and 12 municipalities also received an intensive education campaign (in secondary schools, community conferences, and activities organized by police and firefighters). The incidence and severity of nonfatal road traffic injuries were compared between June to August 2003 (before the campaign) and June to August 2008.
RESULTS:
The total number of injuries in all 20 municipalities in 2003 and 2008 was 907 and 755, respectively. The incidence of injuries decreased in the study period both in the 8 municipalities where only the basic campaign was run (difference in incidence = -0.4; P = .053) and in the 12 municipalities where the intensive campaign was implemented (difference in incidence = -0.5; P < .001); focusing on severity, the incidence of severe injuries decreased or remained the same in the study period in the 2 studied group.
DISCUSSION:
The results are coherent with other European studies and show that an overall downward trend exists but is presumably not a direct consequence of road safety education. This does not mean that such campaigns are useless (they are important to raise awareness) but that they should be supplemented with complementary activities in order to be really effective
Patients’ evaluation of hospital foodservice quality in Italy: what do patients really value?
Get PDFOBJECTIVES: The diagnosis and control of hypertension depend on accurate measurement of blood pressure (BP). The literature on the accuracy of BP recording by health professionals is, however, limited, and no study directly interviewed patients in the hospital setting. This multicenter cross-sectional study aimed at evaluating the compliance to current recommendations on BP measurement by health professionals directly from patients and to investigate potential predictors of higher quality in BP recording. METHODS: A trained nurse interviewed a random sample of adult patients hospitalized for an ordinary admission (except in the emergency room) lasting more than one night, without mental disorder, who had their BP routinely measured by the hospital personnel less than 3h before. The questionnaire contained 15 items on the main procedures that are common to current guidelines. RESULTS: Fourteen public hospitals from seven regions of Italy participated, and 1334 questionnaires were collected. Nine of the recommended practices were followed in the majority (>70%) of BP recordings, whereas some others were infrequent or rare: in 98.6, 82.2 and 81.1% of the participants, respectively, the arm circumference was never recorded, BP was measured only once, and BP was never recorded in both arms. Overall, 10 or more recommended procedures were followed during 33.4% recordings. At multivariate analysis, physicians were less likely than nurses to provide a more accurate BP measurement. CONCLUSIONS: The operator's compliance to some recommendations in BP measurement is unacceptably low. This survey provides detailed indications for medical directors on the procedures and settings to prioritize in educational programs, which are definitely needed. Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited
La riabilitazione intensiva in regime di degenza ospedaliera
No full textNell’ambito degli interventi sanitari di riabilitazione si individuano livelli assistenziali diversi in relazione all’intensità e complessità delle attività sanitarie di riabilitazione e alla quantità e qualità di risorse assorbite. Il processo riabilitativo intensivo può svolgersi in regime di ricovero, day hospital, residenziale, ambulatoriale e domiciliare. Per quanto concerne i pazienti ricoverati, spesso si tratta di soggetti ancora potenzialmente instabili sul piano internistico generale, con necessità di assistenza medica e infermieristica dedicata nell’arco delle 24 ore e che necessitano anche di interventi riabilitativi intensivi onnicomprensivi. La Azienda unità sanitaria locale (Ausl) 7 di Siena, a partire dal 2011, ha deciso di utilizzare posti letto della Medicina per l’attivazione di percorsi riabilitativi intensivi in regime di ricovero. In questo studio si è voluto verificare se il nuovo servizio riabilitativo disposto all’interno del setting assistenziale ospedaliero fosse in grado di rispondere alle esigenze dei cittadini residenti, evitando così fughe intra/extra regionali verso altre Aziende usl
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Full text link“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
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe 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
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