Santullo A.,Director of Health Professio Ausl Rimini |
Fabbri L.,Head Nurse |
Professioni infermieristiche | Year: 2016
INTRODUCTION: The debate about uniform and hand ornament of nurses, technical and supporting staff is focused on two main topics: the risk of infections and the effect on the professional image perceived by patient.PRIMARY OBJECTIVE: to describe how nurses, technical and supporting staff dress their uniform.SECONDARY OBJECTIVE: to verify the use of ornaments of the hands during routine care.METHODS: The survey was conducted in a sample of 503 operators on 67 working contexts in hospital during 14 days. Study questionnaire was composed by 5 items that described behaviors regarding uniform (item 1-2) and the presence of hand ornaments (item 3-4-5).RESULTS: The 17.3% of observed subjects did not wear the uniform and identification badge appropriately; 16.1% had hand ornaments.DISCUSSION: Despite patient delegates, through advisory committee, pointed out the need to identify the workers through the uniform and badge, our results showed inadequate behaviours. The presence of ornaments that interfere with hands hygiene and increase infection risk is a critical issue that has to be periodically monitored. Future interventions are needed to improve behaviours of healthcare personnel.Introduzione: Il dibattito sulla divisa e gli ornamenti indossati dal personale infermieristico, tecnico e di supporto ruota intorno a due temi chiave: il rischio infettivo e l'impatto sull'immagine percepita dall’utente. Obiettivo: Obiettivo primario: descrivere i comportamenti del personale sanitario non medico sulla tenuta della divisa. Obiettivo secondario: descrivere l’uso di ornamenti delle mani durante il turno di lavoro. Metodo: l'indagine, su campo condotta da 7 rilevatori, si è svolta in 67 contesti lavorativi nell’arco di 14 giornate su un campione di 503 operatori. Lo strumento di rilevazione è composto da 5 item che descrivono i comportamenti sulla tenuta della divisa (item 1-2) e sulla presenza di ornamenti delle mani (item 3-5). Risultati: Il 17.3% degli operatori non indossa la divisa completa o il cartellino identificativo; il 16.1% indossa ornamenti delle mani. Discussione: Nonostante i rappresentanti dei pazienti, attraverso i Comitati Consultivi Misti, segnalino la necessità di individuare gli operatori attraverso la divisa ed il cartellino, il livello di adesione a queste indicazioni non è ritenuto soddisfacente dalla Direzione Aziendale. La presenza di ornamenti che interferiscono con l’igiene delle mani e aumentano il rischio di contamina- zione rappresenta un fattore critico che dovrà essere periodicamente monitorato.
Cummings J.L.,Cleveland Clinic |
Ihl R.,Heinrich Heine University Düsseldorf |
Herrschaft H.,University of Cologne |
Hoerr R.,Willmar Schwabe GmbH and Co. KG |
International Psychogeriatrics | Year: 2013
ABSTRACT Background: The Neuropsychiatric Inventory (NPI) is widely used to assess psychopathology in dementia. The scoring involves ratings of frequency and severity, as well as the calculation of a composite score. It was suggested recently that, due to lower variance, the frequency score might be more sensitive to detect treatment-related change and to discriminate active treatment from placebo than the composite score, particularly in milder forms of the disease. Methods: Based on data from three randomized controlled trials in patients with mild to moderate dementia, standardized changes were calculated for both frequency and composite scores for two strata of disease severity. The two strata were formed by dichotomizing the sample along the median score of the short cognitive performance test (SKT) battery. Results: Across all studies and for both severity strata, standardized changes in frequency scores were not consistently larger than those in composite scores and both scores discriminated active treatment from placebo at similar probabilities for type-1 error. Conclusion: Our findings do not support the notion that there is a difference between frequency score and composite score with respect to their sensitivity to treatment-related change. © International Psychogeriatric Association 2012.
PubMed | Statistician, Head Nurse and Director of Health Professio Ausl Rimini
Type: Journal Article | Journal: Professioni infermieristiche | Year: 2016
The debate about uniform and hand ornament of nurses, technical and supporting staff is focused on two main topics: the risk of infections and the effect on the professional image perceived by patient.to describe how nurses, technical and supporting staff dress their uniform.to verify the use of ornaments of the hands during routine care.The survey was conducted in a sample of 503 operators on 67 working contexts in hospital during 14 days. Study questionnaire was composed by 5 items that described behaviors regarding uniform (item 1-2) and the presence of hand ornaments (item 3-4-5).The 17.3% of observed subjects did not wear the uniform and identification badge appropriately; 16.1% had hand ornaments.Despite patient delegates, through advisory committee, pointed out the need to identify the workers through the uniform and badge, our results showed inadequate behaviours. The presence of ornaments that interfere with hands hygiene and increase infection risk is a critical issue that has to be periodically monitored. Future interventions are needed to improve behaviours of healthcare personnel.
Wood C.,Center Hospitalier University Robert Debre |
von Baeyer C.L.,University of Saskatchewan |
Falinower S.,A4 SAS Agency |
Moyse D.,Statistician |
And 2 more authors.
BMC Pediatrics | Year: 2011
Background: Assessment of pain in children is an important aspect of pain management and can be performed by observational methods or by self-assessment. The Faces Pain Scale-Revised (FPS-R) is a self-report tool which has strong positive correlations with other well established self-report pain intensity measures. It has been recommended for measuring pain intensity in school-aged children (4 years and older). The objective of this study is to compare the concordance and the preference for two versions, electronic and paper, of the FPS-R, and to determine whether an electronic version of the FPS-R can be used by children aged 4 and older.Methods: The study is an observational, multicenter, randomized, cross-over, controlled, open trial. Medical and surgical patients in two pediatric hospitals (N = 202, age 4-12 years, mean age 8.3 years, 58% male) provided self-reports of their present pain using the FPS-R on a personal digital assistant (PDA) and on a paper version. Paper and electronic versions of the FPS-R were administered by a nurse in a randomized order: half the patients were given the PDA version first and the other half the paper version first. The time between the administrations was planned to be less than 30 minutes but not simultaneous. Two hundred and thirty-seven patients were enrolled; 35 were excluded from analysis because of misunderstanding of instructions or abnormal time between the two assessments.Results: Final population for analysis comprised 202 children. The overall weighted Kappa was 0.846 (95%CI: 0.795; 0.896) and the Spearman correlation between scores on the two versions was rs= 0.911 (p < 0.0001). The mean difference of pain scores was less than 0.1 out of 10, which was neither statistically nor clinically significant; 83.2% of children chose the same face on both versions of the FPS-R. Preference was not modified by order, sex, age, hospitalization unit (medical or surgical units), or previous analgesics. The PDA was preferred by 87.4% of the children who expressed a preference.Conclusion: The electronic version of the FPS-R can be recommended for use with children aged 4 to 12, either in clinical trials or in hospitals to monitor pain intensity. © 2011 Wood et al; licensee BioMed Central Ltd.
Farese A.M.,University of Maryland, Baltimore |
Cohen M.V.,Intergrated Research Facility |
Stead R.B.,BioPharma Consulting Services |
Jackson III W.,Statistician |
Radiation Research | Year: 2012
Conventional daily administration of filgrastim is effective in reducing the duration of severe neutropenia and enhancing survival following lethal radiation, myelosuppressive cytotoxic therapy or myeloablation and stem cell transplantation. A sustained-duration form of filgrastim, pegfilgrastim has significantly simplified scheduling protocols after chemotherapy-induced neutropenia to a single injection while maintaining the therapeutic effectiveness of daily administration of filgrastim. We examined the ability of a single or double (weekly) administration of pegfilgrastim to significantly improve neutrophil recovery in a rhesus macaque model of severe radiation-induced myelosuppression. Animals were exposed to potentially lethal 6 Gy total-body X radiation. After irradiation all animals received supportive care and were administered either pegfilgrastim at 300 μg/kg on day 1 or day 1 and day 7 post exposure, or filgrastim at 10 μg/kg/day initiated on day 1 post exposure and continued daily through neutrophil recovery. Pharmacokinetic parameters and neutrophil-related values for duration of neutropenia, neutrophil nadir, time to recovery to an absolute neutrophil count ≥500/μL or ≥2000/μL, and days of antibiotic support were determined. Effective plasma concentrations of pegfilgrastim were maintained in neutropenic animals until after the onset of hematopoietic recovery, which is consistent with neutrophil-dependent properties of elimination. Administration of pegfilgrastim at day 1 and day 7 was most effective at improving neutrophil recovery compared to daily administration of filgrastim or a single injection of pegfilgrastim on day 1, after severe, radiation-induced myelosuppression in rhesus macaques. © 2012 by Radiation Research Society. All rights of reproduction in any form reserved.
Lucka T.C.,Charité - Medical University of Berlin |
Pathirana D.,Charité - Medical University of Berlin |
Sammain A.,Charité - Medical University of Berlin |
Bachmann F.,Charité - Medical University of Berlin |
And 6 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2012
Background Despite the chronicity of psoriasis, most systematic reviews focus on short-term treatment. Methods The systematic search strategy and results from the German Psoriasis Guidelines were adapted. To update the data a literature search in Medline, Embase and the Cochrane Library was conducted. The proportion of participants achieving ≤75% decrease in Psoriasis Area and Severity Index (PASI) as well as Dermatology Life Quality Index (DLQI) reduction at different time points were assessed. Trials were summarized with respect to time periods and study designs. Suitable trials were included in a meta-analysis. Particular attention was paid to statistical approaches of handling dropouts. Results A total of 33 articles including 27 trials totaling 6575 patients with active treatment were included in the systematic review. Seven randomized controlled trials were eligible for the meta-analysis. Over a 24 week treatment period infliximab [risk difference (RD) 78%, 95% confidence interval (CI) 72-83%] and ustekinumab 90 mg every 12 weeks (RD 77%, 95% CI 71-83%) were the most efficacious treatments. Adalimumab (RD: 60%, 95% CI 45-74%) showed results within the range of different etanercept dosages (etanercept 50 mg once weekly: RD 62%, 95% CI, 52-72%), (etanercept 25 mg twice weekly: RD 45%, 95% CI 34-56%), (etanercept 50 mg twice weekly: RD 56%, 95% CI 49-62%) and (etanercept 50 mg twice weekly until week 12, then 25 mg twice weekly: RD 50%, 95% CI 42-57%). After 24 weeks a decrease in efficacy for inflximab, adalimumab and etanercept was observed. Conclusions More sufficient data is required to draw reliable conclusions in extended long-term treatment and head-to-head comparisons are necessary. © 2012 European Academy of Dermatology and Venereology.
PubMed | Statistician and University of South Carolina
Type: | Journal: Pharmacotherapy | Year: 2016
To evaluate the odds of achieving viral suppression in HIV patients utilizing antiretroviral therapy as a single-tablet regimen (STR) or multiple-tablet regimen (MTR).Retrospective cohort study.South Carolina Medicaid medical and pharmacy paid claims data were obtained from the South Carolina Revenue and Fiscal Affairs Office; laboratory data were obtained from the South Carolina Department of Health and Environmental Control.A total of 1,536 patients who were dispensed a complete STR (477 patients) or MTR (1059 patients) regimen lasting at least 60 days between January 1, 2006 and December 31, 2013.The analysis examined adherence levels and regimen type on odds of viral load suppression. Regimen adherence levels (90-94%, 85-89%, 80-84% and < 80%) were compared to the gold standard adherence for HIV of 95%. Patients were followed from index date until the earliest date of regimen discontinuation, treatment switch, end of study period, last date of eligibility or death. Differences in outcomes were evaluated by Chi-square, Wilcoxon rank sum statistical tests, and multivariate regression models controlling for covariates. For STR regimens we find that, when compared to 95% adherence, there is no statistical difference in the odds of viral suppression with adherence levels greater than or equal to 80%. However, adherence levels 95% was associated with a greater odds of viral suppression when compared with less than 80% STR adherence (OR 2.57, Dunnetts 95% CI 1.04-6.32). For MTR regimens, there was no statistical difference in the odds of viral suppression for the adherence level 90-94% compared to the 95% adherence (OR 3.59, Dunnetts 95% CI 0.805-16.043). However, the 95% adherence has greater odds of viral suppression compared to all other MTR adherence levels. Additionally, there is no difference in the odds of viral suppression between STR and MTR for all adherence levels.Compared to 95% adherence, STR regimens achieve viral suppression with adherence levels 80%, while MTR regimens require adherence levels 90% to achieve viral suppression in South Carolina Medicaid patients with HIV/AIDS. This article is protected by copyright. All rights reserved.
PubMed | Kidney Life science Institute, Princess Margaret Hospital, Dalhousie University, Credit Valley Hospital and 2 more.
Type: Journal Article | Journal: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis | Year: 2016
Residual renal function (RRF) correlates with mortality and morbidity rates in patients receiving peritoneal dialysis (PD). We examined the effect of a biocompatible PD solution (Gambrosol Trio; Gambro Lundia AB, Lund, Sweden) with lower concentrations of glucose degradation products on rates of decline in RRF. Incident patients at 2 centers in Canada and 1 in Hong Kong were randomized (by minimization) in an open-label parallel group trial to receive Gambrosol Trio or standard PD solution (Dianeal; Baxter Healthcare, Mississauga, Canada) for 2 years. Primary outcome was slope of RRF. Secondary outcomes were urine volumes, fluid and nutrition indices, PD and membrane characteristics, peritonitis rates, adverse events, and PD technique survival. Residual renal function declined by 0.132 mL/minute/1.73 m(2)/month in 51 patients allocated to biocompatible, and 0.174 mL/minute/1.73 m(2)/month in 50 patients allocated to standard PD solution (difference 0.042 mL/minute/1.73 m(2)/month, p = 0.001). Urine volume, body mass index, normalized protein catabolic rates, and fat mass were higher; total body water, peritoneal ultrafiltration, and D/P creatinine did not differ; and serum phosphate, rates of icodextrin, and automated cycler use were lower with Gambrosol Trio use. There were more peritonitis events with Gambrosol Trio use, while PD technique survival did not differ between groups. The use of the biocompatible PD solution Gambrosol Trio was associated with slower rates of decline in RRF, fluid and nutrition benefits, and increased peritonitis rates.ISRCTN26252543.
Mobbs E.J.,University of Sydney |
Mobbs G.A.,Westmead Hospital |
Acta Paediatrica, International Journal of Paediatrics | Year: 2016
Instinctive behaviours have evolved favouring the mother-infant dyad based on fundamental processes of neurological development, including oral tactile imprinting and latchment. Latchment is the first stage of emotional development based on the successful achievement of biological imprinting. The mechanisms underpinning imprinting are identified and the evolutionary benefits discussed. Conclusion It is proposed that the oral tactile imprint to the breast is a keystone for optimal latchment and breastfeeding, promoting evolutionary success. ©2015 The Authors. Acta Pædiatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Pædiatrica.
PubMed | University of Sydney, Statistician and Westmead Hospital
Type: Journal Article | Journal: Acta paediatrica (Oslo, Norway : 1992) | Year: 2016
Instinctive behaviours have evolved favouring the mother-infant dyad based on fundamental processes of neurological development, including oral tactile imprinting and latchment. Latchment is the first stage of emotional development based on the successful achievement of biological imprinting. The mechanisms underpinning imprinting are identified and the evolutionary benefits discussed.It is proposed that the oral tactile imprint to the breast is a keystone for optimal latchment and breastfeeding, promoting evolutionary success.