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BackgroundRegular physical activity (PA) contributes to the primary and secondary prevention of several chronic diseases and reduces the risk of premature death. Physical inactivity is a modifiable risk factor for cardiovascular disease and a variety of chronic disorders such as diabetes, obesity, hypertension, bone and joint diseases (eg, osteoporosis and osteoarthritis), depression, and colon and breast cancer. Population aging and the related increase in chronic diseases have a major impact on the health care systems of most Western countries and will produce an even more significant effect in the future. Monitoring PA is a valuable method of determining whether people are performing enough PA so as to prevent chronic diseases or are showing early symptoms of those diseases. ObjectiveThe aim of this study was to estimate the accuracy of wearable devices in quantifying the PA of elderly people in a real-life setting. MethodsParticipants aged 70 to 90 years with the ability to walk safely without any walking aid for at least 300 meters, who had no walking disabilities or episodes of falling while walking in the last 12 months, were asked to walk 150 meters at their preferred pace wearing a vívoactive HR device (Garmin Ltd) and actual steps were monitored and tallied by a researcher using a hand-tally counter to assess the performance of the device at a natural speed. A Bland-Altman plot was used to analyze the difference between manually counted steps and wearable device–measured steps. The intraclass correlation coefficient (ICC) was computed (with a 95% confidence interval) between step measurements. The generalized linear mixed-model (GLMM) ICCs were estimated, providing a random effect term (random intercept) for the individual measurements (gold standard and device). Both adjusted and conditional ICCs were computed for the GLMM models considering separately the effect of age, sex, BMI, and obesity. Analyses were performed using R software (R Foundation for Statistical Computing) with the rms package. ResultsA total of 23 females and 26 males were enrolled in the study. The median age of the participants was 75 years. The Bland-Altman plot revealed that, excluding one observation, all differences across measurements were in the confidence bounds, demonstrating the substantial agreement between the step count measurements. The results were confirmed by an ICC equal to .98 (.96-.99), demonstrating excellent agreement between the two sets of measurements. ConclusionsThe level of accuracy of wearable devices in quantifying the PA of elderly people in a real-life setting that was found in this study supports the idea of considering wrist-wearable nonmedical devices (widely available in nonspecialized stores) as reliable tools. Both health care professionals and informal caregivers could monitor the level of PA of their patients.

BACKGROUND: Fabry disease is characterized by deficient expression/activity of α-GalA with consequent lysosomal accumulation in various organs of its substrate Gb3. Despite enzyme replacement therapy, Fabry disease progresses with serious myocardial, cerebral and renal manifestations. Gb3 accumulation may induce oxidative stress (OxSt), production of inflammatory cytokines and reduction of nitric oxide, which may impact on Fabry diseases clinical manifestations. METHODS: OxSt status was characterized in 10 patients compared with 10 healthy subjects via protein expression of p22phox, subunit of NADH/NADPH oxidase, (Western blot), Heme oxygenase (HO)-1 levels (ELISA), antioxidant/anti-inflammatory, lipid peroxidation as malondialdehyde (MDA) production (colorimetric assay), phosphorylation state of Extracellular Signal Regulated Kinase (ERK)1/2 and Myosin Phosphatase Target Protein (MYPT)-1 (Western blot), marker of Rho kinase activation, both involved in OxSt signaling. Cardiac left ventricular (LV) mass was also evaluated (M-mode echocardiography). RESULTS: LV mass was higher in Fabrys males (123.72±2.03SEM g/m2) and females (132.09±6.72g/m2). p22phox expression was also higher in patients (1.04±0.09 d.u. vs 0.54±0.05 d.u. p

A prevalent symptom among Inflammatory Bowel Disease (IBD) patients is fatigue, characterized by a persistent sense of energy depletion that affects all aspects of daily life. This review aims to evaluate nursing interventions reported in the literature to alleviate fatigue in IBD patients. A comprehensive search was conducted across four electronic databases—PubMed, CINAHL, Cochrane, and Scopus—and four scientific journals: "Gastroenterology", "Inflammatory Bowel Disease", "Journal of Crohn's and Colitis", and "United European Gastroenterology Journal". Inclusion criteria were clinical trials involving adult IBD patients in remission or mild disease activity. Out of 234 studies, 2 were selected for review. These studies assess the effectiveness of Solution-Focused Therapy (SFT) that emphasizes solving problems and developing strategies for improvement, and Problem-Solving Therapy (PST) that focuses on identifying problems and coping strategies. SFT showed a positive impact on fatigue with a significant improvement in the Checklist Individual Strength after three months: 45.5% in the control group, 85.7% in the SFT group, and 60% in the PST group, but its impact declined over time. Additionally, SFT demonstrated potential for reducing healthcare costs compared to standard of care and PST. Further research is needed to provide nurses interventions for managing fatigue in IBD patients. The review protocol has been registered at OSF.io. [ABSTRACT FROM AUTHOR]

Purpose: This study aim was to assess effectiveness of ultrasonic maintenance debridement on biofilm removal process and consequently on chronic wounds healing, by implementing a standardized wound care procedure. Methods: The procedure consists of: * TIME evaluation * evaluation with Push Tool Scale 3.0 (PTS); * application of anaesthetic cream (lidocaine 5%) for 15/20 minutes; * cleansing with surfactant; * mechanical ultrasonic debridement at 15-day intervals * dressing * Wound re-assessment at regular intervals of 7 days using the Push Tool Scale 3.0. Results: This standardized procedure was performed on 10 patients with chronic vascular ulcers: * Average age 78.6 years * 5 females * 4 with co-morbidities (diabetes and/or arteriopathy) * 6 in the perimalleolar site * 4 on the leg * 6 recurrent wound (onset on average 492 days before the start of treatment, in a range from 120 to 1080) - details in table 1. All 10 subjects show improvement with an average reduction of 7.6 PTS points (range 1-15) over an average treatment period of 120 days (range 30-150). The average PTS score at intake was 13.2 (range 16-8), at re-evaluation 5.6 (range 14-0). In 4 subjects full recovery was achieved within an average of 134 days (range 150-120). Conclusions: although cautiousness is required when analysing the data, due to the number of cases observed being too small to be statistically meaningful, the results show the effectiveness of the procedure and encourage undertaking a more extensive study, examining a greater variety and number of difficult ulcers and possibly testing different interval between the debridement sessions. [ABSTRACT FROM AUTHOR]

Aim: Describe the ability to identify the movement performed by a patient in bed using four pressure sensors and assess how an algorithm describes the movements of the person in bed using data from the sensors to develop continuous assessment of pressure ulcers risk. Method: Data were collected through a standardized videotaped session in which each subject performed a series of movements/ positions in bed (figure 1). Data labeling was manually performed by comparing them with the images. Results / Discussion: Data analysis has not yet been completed for all the data collected, but that of the first 128 volunteers allows the description of some preliminary results to confirm the feasibility of the system developed and the labeling of signals coming from the sensors that were able to identify the subject's movements. The study conducted so far has demonstrated the feasibility of the system of data collection allowing us to confirm the usefulness and reliability of the data stream transmitted by the bed sensor system, the proper labeling of the originated data, and a proper implementation of the data collection scheme that has so far been used, enabling the development of an automated data labeling system (neural network) that will enable the automation of the active mobilization monitoring system of the bed-occupant. Conclusion: There are many benefits that the tool could bring to clinical practice, optimizing preventive interventions and individualizing nursing care, but completion of the study and a subsequent trial in the end-use setting by enrolling subjects from a population at risk of pressure ulcers is needed to confirm this hypothesis. [ABSTRACT FROM AUTHOR]

Aim: Every year in Western countries, venous leg ulcers (VLU) affect about 1% of the population and 3% of over 80 years old with a high 12-month recurrence rate (from 18% to 28%). If not treated properly, ulcers can lead to serious consequences, compromising limb function and quality of life. Method: This study was divided in two phases. In the first, the translation, cultural adaptation, and psychometric validation of the VeLUSET (Venous Leg Ulcer Self Efficacy Tool) have been performed in the Italian population through a Bayesian approach. The second phase aims to describe the levels of self-care and knowledge of patients with VLU, by administering questionnaires "VeLUSET" and "Educational interventions in patients with venous leg ulcers" to patients with VLU in follow-up at an outpatient clinic. Results / Discussion: 65 subjects with a median age of 78 years (interquartile range (IQR) 67-82) with a higher prevalence of the male gender (n=45, 69%) were enrolled. They had vascular ulcers on average for 3 years (IQR 1-17 years), in 68% of cases it was a relapse (44 subjects) and 65% received a specific education about VLU. Subjects with specific training are more autonomous in management capacity of vascular ulcers, avoiding recourse to the services of the National Health System (p=0.001). There is also a positive correlation between self-care ability and knowledge scores (r=0.27, p=0.034). Conclusion: These results show that patients' ability to self-care is related to their level of knowledge. Interventions aimed at improving patients' knowledge take on relevance aiming at promoting better self-care. [ABSTRACT FROM AUTHOR]

Aim: The main objective of this study is to assess whether the Ankle Brachial Index (ABI) is used by nurses in the treatment of vascular ulcers of the lower limbs, before compression treatment, to exclude arterial disease. The secondary objective is to assess the knowledge of nurses about the diagnosis of vascular leg ulcers and the compression treatment. Method: medical records were assessed to check whether the ABI is used in daily clinical practice and an e-questionnaire was administered to nurses employed in a home care nursing service to test their knowledge on ABI and compression treatment. Results / Discussion: 100 patients were enrolled. ABI was applied only in 24% of VLU patients. Only in 44% of cases with an ABI score ≤ of 0.9 nurses referred the patient to a vascular consultant. The multi-component inelastic bandage is the most used compression treatment, although there are some gaps in the knowledge of the criteria for selecting patients for this treatment. 29% of the patients studied were not applied any compression therapy. Conclusion: since ABI is fundamental to implement a compression therapy without negative effects, the reason why nurses do not use it is missing (training, organizational, or structural deficiencies?). To improve the treatment of VLU, staff must come trained in the use of ABI, to increase its use in the initial assessment phase. The review of medical records and patients' files has been useful to identify the issue above described: it could be a methodology to be applied frequently in the periodic assessment of any retraining need of healthcare personnel. [ABSTRACT FROM AUTHOR]

Aim: assess whether a very simple educational intervention can improve self-care and disease knowledge of patients with venous leg ulcers (VLU). Method: patients attending an outpatient clinic were randomly assigned to receive additional information (intervention) or standard of care (control). All subjects filled-in two questionnaires at baseline and after two weeks: "VeLUSET" and "Educational interventions in patients with venous ulcers in the legs" (EI), measuring levels of self-care and disease knowledge, respectively. Results / Discussion: 29 subjects were enrolled, 21 females, median age of 75, most in follow-up for ulcer recurrence (median disease duration: 3 years). Near half of them were autonomous in wound dressing. Three quarters already received information on VLU, mostly from the healthcare personnel at the clinic. No significant difference emerged between the two groups after randomizatione. After two weeks, the mean VeLUSET score increased from 227 to 271 for intervention (p<0.001) and from 200 to 213 for control (p=0.33) -- fig.1. For EI questionnaire, at t1 the mean score increased from 6.3 to 11.5 for intervention (p<0.001) and from 5.8 to 6.9 for control (p=0.28) -- fig.2. Conclusion: a simple intervention could be useful for improving both self-care and disease knowledge. Despite considering the limits of the small sample size and the short duration of observation, emerge a clear indication to distribute 'instructions for use' to VLU patients. Further research should consider medium-long-term and multicenter data collection to provide generalizable results. In this perspective the study team is developing a smartphone app for simple selfcare and knowledge screening. [ABSTRACT FROM AUTHOR]