21 research outputs found
Prevention strategies of the risk of violence and aggression towards nurses in renal units
No full textBackgroundNursing, between healthcare professions, is the most at risk of violence and aggression. Most healthcare organizations rely on training as the primary strategy for the prevention of violence. Very little is known about the key factors for prevention against nurses: staff education, training and risk assessment.ObjectivesThe aim is to verify if the number of observed episodes of violence and aggression in renal units are associated with structural and prevention managerial strategies.DesignAn observational, cross-sectional study.ParticipantsThey were part of a convention sample of participants in the European Dialysis and Transplant Nurses Association/European Renal Care Association Conference of 2019, who understood the English Language and had a smartphone or tablet.MeasurementsThe tool used was a questionnaire developed by Zampieron in 2010, with closed questions, focused on violence and aggression's prevention and management.ConclusionsIn conclusion our study found that organizational and managerial strategies to address violence and aggression are highly correlated with observed violence in unit. Nurses are encouraged to become proactive by participating in prevention committees and policies, attending prevention training offered by unit, and reporting all incidents including those witnessed
On stochastic optimization problems and an application in finance
No full textJosef Anton Strini analyzes a special stochastic optimal control problem. The problem under study arose from a dynamic cash management model in finance, where decisions about the dividend and financing policies of a firm have to be made. Additionally, using the dynamic programming approach, he extends the present discourse by the formal derivation of the Hamilton-Jacobi-Bellman equation and by examining the verification step carefully. Finally, the treatment is completed by solving the problem numerically. Contents Optimal Control of Markov Processes A Singular Stochastic Control Problem Dynamic Programming Approach and Consequences Target Groups Researchers and students in the fields of mathematics, probability theory and applied mathematics in financial and actuarial industry Mathematicians from the financial and actuarial industry The Author Josef Anton Strini wrote his master’s thesis under the supervision of Prof. Dr. Stefan Thonhauser at the Institute of Statistics at Graz University of Technology, Austria
Nurse‐perceived facilitators and barriers to palliative care in patients with kidney disease: A European Delphi survey
No full textBackground:The palliative care phenomenon is increasingly invested in all medicine and nursing fields, as care for people with kidney disease who do not wish to embark on dialysis: it encompasses a palliative approach to shared decision-making. To deliver patient-centred optimal care, nephrology healthcare staff should be knowledgeable about palliative care and the appropriate conservative management approach.Objective:This paper aimed to explore, using a Delphi survey, the barriers and facilitators to palliative care in patients with kidney disease.Design: An e-Delphi technique with three questionnaire rounds was performed; statements were generated using Likert scales. Participants and Measurements: A list of 80 statements related to palliative care in patients with kidney disease was divided into facilitators and barriers. Questionnaires were administered to 13 nephrology nurse experts in some European countries. Results: Seven items were removed from the list of 80 statements after the first round of the Delphi study; eight items achieved a significant change of the mean between round two and three, whereas internal stability emerged in all the remaining items. Conclusions: Specific training and education in palliative care emerged as a facilitator, as well as the role of spiritual and beliefs and the role of family and caregiver. The main barriers were represented by the differences in cultures, beliefs, and practices and by the lack of experience in the role of the staff in palliative care. These statements provide a platform for future research to improve palliative care practice in patients with kidney disease.</p
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No full textBackground: Children who develop Acute Kidney Injury may start renal replacement therapy (RRT) in Paediatric or Neonatal Intensive Care Units (hereafter PICU or NICU); RRT can be delivered either by paediatric dialysis nurses or by critical care nurses. In both case, nurses devoted to this task must have a high level of competence in providing care to children receiving haemodialytic treatment in a specific technological environment. Aim: The objective of this research was to investigate which models have been adopted to organize nursing care in RRT management in different Italian PICU and NICU, and to explore the training of ICU nurses on the management of RRT. Methods: A multi-centre survey was conducted through an online questionnaire directed to the Italian PICU and NICU nurse coordinators. Results: A total of 15 Intensive Care Units (12 PICU and 3 NICU) in 12 hospitals were involved. The mean nurse/patient ratio in these units is 1:3. In 72.7% of critical care units, dialysis treatment is delivered by critical care nurses belonging to the unit itself, while in 27.3% of units paediatric dialysis nurses are in charge of dialysis treatment in collaboration with critical care nurses. In 25% of surveyed units there is some structured form of collaboration between Paediatric Dialysis nurses and critical care nurses. However, 75% of units did not respond to this specific question. The different units adopt various forms of RRT training for nursing staff. Conclusion: The scenario resulting from this analysis showed how in our sample of Italian hospitals there is no standard practice for RRT nursing management. In addition, although various forms of training for nursing staff exist, a proper educational programme and/or a standardized specific training about RRT management for nursing staff is not in place in the surveyed hospitals. Relevance to clinical practice: The lack of standardized protocols or guidelines for RRT delivery to critically ill children can compromise their safety. The structuring of these protocols and the production of best clinical practice guidelines would allow standardization of the nursing management of the RRT and of the corresponding training. This may help to provide the proper care and to guarantee the patients' safety
Plastic cannulae versus metal needle cannulation in haemodialysis: Results of an international survey from the nurse perspective
No full textBACKGROUND: In haemodialysis is key to successfully obtaining cannulation of the arteriovenous fistula (AVF). The literature agrees that cannulation, failing in the initial maturation period, can lead to delayed dialysis, haematoma, scarring, needle phobia and loss of confidence in the cannulator. The introduction of plastic cannulae for haemodialysis has changed cannulation practice positively, preventing frequent complications such as infiltration or trauma. Despite that, most countries have continued to use metal cannulation, in particular in Europe. This study investigates the common use of plastic cannulae versus metal needles for cannulation in dialysis units and explores the implications of focusing on the side effects of cannulation.METHODS: The study is a cross-sectional survey. A questionnaire was created by a team of experts from the European Dialysis Transplant Nurse Association/European Renal Care Association (EDTNA/ERCA) to address the study's aims and sent online to nurse members.RESULTS: Data collected suggested a strong resistance towards using plastic cannulae, with few respondents claiming to use these cannulas. Most of the respondents were female (74%), Europeans, working in nephrology for more than 10 years and most worked in the public sector. There was a strong correlation between the use of plastic cannulae and fewer adverse events in elbow located AVF and newly created or fragile AVF.CONCLUSIONS: The results are in line with the current literature. Possible resistance to the use of the plastic device includes the difference in cost between the two devices in favour of metal needles. However, it should be considered that the lower number of adverse events, in particular infiltration and haematoma caused by the metal needle, involves a considerable saving both in money and in terms of time and distress for the patient.</p
Scale of Assessment of Caregiver Care Burden of People With Dementia: A Systematic Review of Literature
No full textCases of dementia have increased significantly in recent years. The family represents the main cornerstone of assis-tance to the elderly suffering from dementia, in particular the caregiver. Family members who take on the role of caregiver are subjected to physical, psychological, emotional, social and financial stress, which can be conceptualised with the term "burden". The aim of this study was to investigate which tools are best suited to measure the type of burden based on the type of dementia for each caregiver. A literature search was undertaken in MEDLINE, CINHAL and The Cochrane Database in September 2022, including articles from the last 20 years and using a combination of keywords and defined inclusion criteria. This literature review has been performed according to the PRISMA statement. From a total of 116 articles regarding the use of burden rating scales for caregivers, 18 scales were selected. The review provides a useful overview of burden assessment scales, classified into three categories, one-dimensional, multidimensional, or distinct concept with a subjective and objective component, in order to adopt appropriate strategies to assess caregiver burden and improve the quality of their health, both in the community and in hospitals. Indeed, the domestic context is the most studied as there is a greater risk of developing the burden of the caregiver: for this reason, some scales include the assessment of both the caregiver and the patient receiving treatment
LIGNIN VALORIZATION: FROM MOLECULES TO MATERIALS
No full textLIGNIN VALORIZATION: FROM MOLECULES TO MATERIALS
Chiara Allegretti1*, Gianmarco Griffini1, Arno Cordes2, Simon Fontanay3, Alberto Strini4, Julien Troquet3, Stefano Turri1, Paola D’Arrigo1,5
1Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico of Milano,
p.zza L. da Vinci 32, Milano, Italy
2ASA Spezialenzyme GmbH Am Exer 19 C, Wolfenbüttel, Germany
3Biobasic Environnement, Biopôle Clermont Limagne, Saint-Beauzire, France
4Construction Technologies Institute - National Research Council of Italy (ITC-CNR), San Giuliano Mil., Italy
5The Protein Factory Research Center, via Mancinelli 7, Milano, Italy
*Corresponding author: [email protected]
Lignin is a highly complex phenolic matrix that acts as a binder in plants conferring them structural integrity and strength, and is one of the three major subcomponents of lignocellulosic biomass. Although burning lignin is still considered a valuable contribution in saving fossil sources, the exploitation of this extremely abundant natural polymer in terms of higher value-added applications is very appealing as it represents the only viable source to produce aromatic compounds as fossil fuels alternative. Due to the very broad composition in terms of molecular weight of the raw material, a pretreatment strategy becomes necessary for an efficient lignin valorization as macromolecular building block for polymeric materials or as precursor for aromatic small molecules.
To this end, a physical fractionation has been performed in this work, where Lignin (ProtobindTM1000) in a water/ethanol solution is subjected at first to microfiltration under vacuum in order to eliminate the insoluble residues. The permeate then undergoes a cross-flow filtration process using two subsequent membranes with cut-off of 3 kDa and 1 kDa. All the retentates and permeates have been fully characterized by GPC, GC-MS, ESI-MS, DSC, TGA and FT-IR.
This procedure is an essential tool for a thorough exploitation of the main three different fractions recovered, namely a high, an intermediate and a low molecular weight fraction. The first one is characterized by the presence of high molecular weight polymers and is used without further chemical modification for developing bio-based polymeric materials;[1] the last one can be separated by chromatography into small aromatic molecules for preparative organic chemistry; whereas the middle fraction, characterized by an intermediate molecular weight, is the ideal starting material for oxidative depolymerization assays.[2,3] On this fraction, a new cascade process has been investigated involving at first a chemical/photochemical step aiming at a partial conversion of macromolecules to low molecular weight intermediates followed by a biocatalytic step performed by different classes of O2-dependent laccases (EC 1.10.3.2) in the presence of TEMPO as a mediator. Promising results have been obtained and extensive research is now in progress.
Acknoledgements:
COST Action CM1303 Systems Biocatalysis
ValorPlus Project (grant agreement no FP7-KBBE-2013-7-613802
Fall Risk Assessment Scales: A Systematic Literature Review
No full textBackground: Falls are recognized globally as a major public health problem. Although the elderly are the most affected population, it should be noted that the pediatric population is also very susceptible to the risk of falling. The fall risk approach is the assessment tool. There are different types of tools used in both clinical and territorial settings. Material and methods: In the month of January 2021, a literature search was undertaken of MEDLINE, CINHAL and The Cochrane Database, adopting as limits: last 10 years, abstract available, and English and Italian language. The search terms used were “Accidental Falls” AND “Risk Assessment” and “Fall Risk Assessment Tool” or “Fall Risk Assessment Tools”. Results: From the 115 selected articles, 38 different fall risk assessment tools were identified, divided into two groups: the first with the main tools present in the literature, and the second represented by tools of some specific areas, of lesser use and with less supporting literature. Most of these articles are prospective cohort or cross-sectional studies. All articles focus on presenting, creating or validating fall risk assessment tools. Conclusion: Due to the multidimensional nature of falling risk, there is no “ideal” tool that can be used in any context or that performs a perfect risk assessment. For this reason, a simultaneous application of multiple tools is recommended, and a direct and in-depth analysis by the healthcare professional is essential
The Role of the Nurse in Informed Consent to Treatments: An Observational-Descriptive Study in the Padua Hospital
No full textBackground: The process to obtain valid informed consent in healthcare reflects many aspects. Healthcare professionals that take care of the patient must provide him all the necessary information and verify his understanding, considering individual characteristics. Nurses are one of the main participants in this process. Objective: This study assesses nurses’ perceptions of their role in the informed consent process. Material and Methods: An observational study involving 300 nurses operating in 13 wards of the Padua Hospital, through the submitting of a questionnaire in the period November–December 2018. Results: The final sample is made up of 206 nurses—27 males (13.11%) and 179 females (86.89%). Work experience, on average 15 years, is significant in determining the answers to questions about opinions and experiences. Age is significant in determining how often nurses provide information to the patient’s family members about the actions to be taken after discharge. The ward was decisive in the responses related to information provided to patients on the nursing care level and the actions to be taken after discharge, and the definition of the nurse’s duties. Conclusions: The data collected show the need for interventions to reduce the causes of difficult that the nurse has in informing patients
Violence and aggression prevention and management strategies in renal units: a survey after 10 years
No full textBackgroundNursing is considered the healthcare profession at most risk of violence. Violence in the workplace is a complex construct difficult to manage and against health workers has implications for the entire health system. A limited number of studies have evaluated this phenomenon in renal units, and there has been little related work since Zampieron's study of 2010.ObjectivesTo describe prevention and management strategies 10 years after the last survey of Zampieron and to identify what has changed in the management of violence.DesignAn observational, cross-sectional study.ParticipantsA convenience sample including all nurses participating in the European Dialysis and Transplant Nurses Association/European Renal Care Association Conference of 2019, who understand the English language and have a smartphone or tablet.MeasurementsA questionnaire developed by Zampieron was used. The first part collected data concerning the characteristics of the participants' workplace; the second part included closed questions focused on the strategies of management and prevention of violence.ResultsViolence is still a frequent event in renal units, despite measures adopted as education, training, formal incident reporting procedures and indoor safety measures. Much more has been invested in recent years in the prevention of violence in the workplace through specific courses, which have led to greater complaints and reporting of episodes.ConclusionsThis study shows how actions regarding prevention and management of violence towards nurses have been implemented in renal units over the last 10 years and it suggests the greatest investment in recent years has been made in terms of staff training and education
