Search

. Project for an Health Centre. For an interpretation of the post-pandemic as a time of experimentation. The problems in health care, highlighted by the pandemic that so severely affected the Bergamo area, led to the activation of a multidisciplinary group, that started a path of reflection and proposals, to move the health care from the hospitals to the districts. The consultations and meetings involved not only institutional representatives of health and social care but also schools, municipalities and voluntary associations, and started several projects (some are already ongoing) that promote the contacts with the community, in the idea that health can be achieved only through the involvement and participation of and with the citizens. A model has been proposed to build a district clinic, and several initiatives have been planned: to identify, orient and support adolescents with mental distress; to map existing social and voluntary services and to promote reciprocal knowledge of professionals involved; to improve peer support among students and the self-esteem in students with a troubled background. All initiatives are characterized by a broad involvement of all stakeholders and a down-top approach of strategies and interventions. The experience presented is a blueprint of involvement, participation, and mutual engagement of professionals, lay citizens and communities.

Objectives: to assess the role of four administrative healthcare databases (pathology reports, copayment exemptions, hospital discharge records, gluten-free food prescriptions) for the identification of possible paediatric cases of celiac disease., Design: population-based observational study with record linkage of administrative healthcare databases. SETTING AND PARTICIPANT S: children born alive in the Friuli Venezia Giulia Region (Northern Italy) to resident mothers in the years 1989-2012, identified using the regional Medical Birth Register., Main Outcome Measures: we defined possible celiac disease as having at least one of the following, from 2002 onward: 1. a pathology report of intestinal villous atrophy; 2. a copayment exemption for celiac disease; 3. a hospital discharge record with ICD-9-CM code of celiac disease; 4. a gluten-free food prescription. We evaluated the proportion of subjects identified by each archive and by combinations of archives, and examined the temporal relationship of the different sources in cases identified by more than one source. RESULT S: out of 962 possible cases of celiac disease, 660 (68.6%) had a pathology report, 714 (74.2%) a copayment exemption, 667 (69.3%) a hospital discharge record, and 636 (66.1%) a gluten-free food prescription. The four sources coexisted in 42.2% of subjects, whereas 30.2% were identified by two or three sources and 27.6% by a single source (16.9% by pathology reports, 4.2% by hospital discharge records, 3.9% by copayment exemptions, and 2.6% by gluten-free food prescriptions). Excluding pathology reports, 70.6% of cases were identified by at least two sources. A definition based on copayment exemptions and discharge records traced 80.5% of the 962 possible cases of celiac disease; whereas a definition based on copayment exemptions, discharge records, and gluten-free food prescriptions traced 83.1% of those cases. The temporal relationship of the different sources was compatible with the typical diagnostic pathway of subjects with celiac disease., Conclusions: the four sources were only partially consistent. A relevant proportion of all possible cases of paediatric celiac disease were identified exclusively by pathology reports.

Impaired dental status in the mentally retarded is one of the principal secondary conditions limiting daily activities such as eating and talking, causing pain, loss of sleep and function, and low self-esteem. Little information is available regarding the dental status of the mentally retarded disable attending day centers in Italy. The aim of this study was to provide such information, enrolling 6 day centers in the Veneto region comprising a total number of 65 mentally retarded subjects aged between 19 and 44 years of age. Data were collected using 2 different instruments. Results showed a significantly higher number of teeth missing in the mentally disabled (9.2) in comparison to the control group (2.3), although this figure is lower than the international one.

The study has evaluated the subjective pain treatment perception in hospitalized patients with an observational cross-sectional design, using a measurement model based on the American Pain Society-Pain Outcome Modified-Questionnaire (APS-POQ-M). The survey has been designed accordingly with other published studies for results comparison. Data were collected from 350 hospitalized patients - with diagnoses highly related to pain - in 46 medical-surgical units in a large university hospital. Results revealed that 73% of the interviewed declared pain. Current pain, ranged from 0-10, had a median score of 3.8. The worst pain over the last 24 hours scored 6.8 where the 24-hours average pain was 4.9. The patients surveyed reported interference caused by pain in the daily activity, however, they were also generally satisfied with the ongoing pain control treatment. Statistically significant relationships have been found between level of satisfaction with treatment and mood and relationships but none with pain.

Delirium is a common and serious complication for hospitalized elderly people. Early detection of risk and preventive treatment may significantly reduce delirium and its consequences. In Inouye's study of elderly people with delirium (1993), an interesting predictive model was proposed ,but never applied, for hospitalized elderly. The aim of this study was to test the effectiveness of IPD, a standardized package of caring activities, in the prevention of delirium in inpatient elderly The study consisted of an experimental controlled randomized trial with standardized treatment (Prevention of Delirium Interventions - IPD) with 30 subjects in the experimental group and 30 comparable subjects in the control group. Subjects were recruited if they obtained a score of 24 or less in the Mini Mental State Examination (MMSE). All the subjects have been assessed on the first, second, fourth and seventh day of their hospital stay according to the MMSE, Barthel Index, Tinetti Balance and Gait Scale, Neecham Confusion Scale, and Delirium Rating Scale. The method of assessment was the Confusion Assessment protocol. There was a statistically and clinically significant reduction in both the risk of delirium and related events in the treatment group compared to the control. Therefore, the IPD model proved to be highly effective in comparison to traditional care for elderly inpatients.

Two dimensions are identifiable in nursing hospital caring: a) nurse activities based on nurse critical evaluation, carried-out in order to achieve patients highest independence; b) nurses activities implementing routinely care and medical prescriptions. Therefore, in order to improve the appropriateness of their evaluations, nurses should measure patients level of dependence using valid and reliable instruments. The study was designed to develop and test a dependency scale for hospitalized patients, in order to better identify their needs of nursing care; the study was carried out at Udine University Hospital. The instrument developed (ADI 8) is a eight-ranks scale. A comparative validation between ADI 8, Barthel Index ans Swiss Grid (MS) proved that ADI 8 has more discriminative power for medium dependency level subjects. Moreover, ADI 8 showed less tendency to overestimate than Bartel Index. Reliability test was carried out using paired observers in blind mode. Kendall statistics proved that ADI 8 possess high reliability for each factor and overall (.80).

Academic education and professional role, both enhancing status and opening new paths for further developments. Consequently, there is a wide a compulsory interest to develop scientific research in the nursing field and to increase the number of studies published in the nation each year. This study reviewed the areas of inquiry and characteristics of research articles published in Italian journals from 1998 throughout 2001. Phenomena of interest, research design, sampling, and internal consistency have been used as evaluation criteria. Of 64 articles identified, only 52 have been reviewed (81%) because matching the selection criteria. Of the reviewed studies, 73% focus on clinical aspects, 21.2% on management, and 5.8% on nursing education. The majority of the reviewed studies use cross or longitudinal observational design, correlational (3.8%), or quasiexperimental design (5.2%). Convenience selection was the most used sampling method when reported. Data analysis was mostly done using descriptive statistics with only few exceptions. The majority of the reviewed studied adopt a quantitative approach. A nurse was principal investigator only in 58% of the studies.

In this paper the author analyzes commonalities and differences between scientific inquiry and diagnostic assessment, to highlight the thought and method rigorousness implied in the nursing diagnosis. The first part of the paper is dedicated to explore the relationship between the subjectivity of the heuristic attitude and the objectivity of the scientific methodology. In the second part, the use of inductive and deductive approaches in diagnostic inquiry are compared and the validity of their outcomes is discussed. Finally, the last section describes concepts and methods mostly used and is completed by an analysis of criteria for classification useable in nursing diagnosis.

In order to guarantee the quality of health care, it is necessary that the care focus on patients' needs. This requires that care givers possess diagnostic competency skills that allow them to quickly identify the patients' needs, using suitable methods and instruments. In Italy, the development of diagnostic competency skills is generally overlooked in nursing schools; this is due in part to the lack of applied and experimental educational models in teaching and training. During the 1992-1993 year, a didactic teaching intervention to assist students in the acquisition of diagnostic skills was tested. The sample included all students in the third year class of the San Miniato nursing school. The Zanotti's model "Nursing as a stimulus for health-harmony" was used as framework. The purpose of the research was to test: (a) validity and reliability of a new needs' analysis model; (b) the effectiveness of a didactic method for the acquisition of such a model by the students. Students enhanced their skills in data assessment and shifted from the medical perspective to the nursing perspective in using those data to evaluate the patient's status.

A longitudinal investigation developed in the Regione Veneto has focused on the motivations which lead 2,500 young people per year to choose the nursing school and on the information on the school and the profession which are available for them. The ground motivations which seem to guide to choice appear to be mostly of the idealistic-humanitarian type, while the image of the nursing profession shares the characteristics of a low professional and social role. The investigation has also explored the motivations which lead 15% of the candidates to leave the school very early on, and provides a profile of those characteristics of the Regional Schools which are judged by the young candidates as positive or negative.