Risultati per: Il problema disfagia nelle cure primarie. Prima parte

To the Editor After reading the Review by Tarantino et al recently published in JAMA Oncology, we became very excited to hopefully see a change in the paradigms for ERBB2-positive metastatic breast cancer (MBC) but also intrigued by some provocative suggestions.

Almeno metà delle regioni non ha rinnovato le Usca, le squadre speciali di medici e infermieri impegnate fin dal marzo 2020 in prima linea

Objectives
The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project implemented an evidence-based intervention that offers a combination of pharmacotherapy and behavioural support to tobacco-dependent inpatients. Understanding key characteristics of CURE’s implementation strategy, and identifying areas for improvement, is important to support the roll-out of nationwide tobacco dependence services. This study aimed to (1) specify key characteristics of CURE’s exiting implementation strategy and (2) develop theoretical-informed and stakeholder-informed recommendations to optimise wider roll-out.

Design and methods
Data were collected via document review and secondary analysis of interviews with 10 healthcare professionals of a UK hospital. Intervention content was specified through behaviour change techniques (BCTs) and intervention functions within the Behaviour Change Wheel. A logic model was developed to specify CURE’s implementation strategy and its mechanisms of impact. We explored the extent to which BCTs and intervention functions addressed the key theoretical domains influencing implementation using prespecified matrices. The development of recommendations was conducted over a two-round Delphi exercise.

Results
We identified six key theoretical domains of influences: ‘environmental context and resources’, ‘goals’, ‘social professional role and identity’, ‘social influences’, ‘reinforcement’ and ‘skills’. The behavioural analysis identified 26 BCTs, 4 intervention functions and 4 policy categories present within the implementation strategy. The implementation strategy included half the relevant intervention functions and BCTs to target theoretical domains influencing CURE implementation, with many BCTs focusing on shaping knowledge. Recommendations to optimise content were developed following stakeholder engagement.

Conclusions
CURE offers a strong foundation from which a tobacco dependence treatment model can be developed in England. The exiting strategy could be strengthened via the inclusion of more theoretically congruent BCTs, particularly relating to ‘environmental context and resources’. The recommendations provide routes to optimisation that are both theoretically grounded and stakeholder informed. Future research should assess the feasibility/acceptability of these recommendations in the wider secondary-care context.

Comunicato del 31/05/2022 n°29

Sono stati 2,8 milioni gli screening oncologici saltati nei primi 17 mesi di pandemia. Manca un programma di recupero delle cure saltate e il Piano oncologico

L’assistenza domiciliare nel nostro Paese c’è sempre stata, sulla carta, o realizzata a macchia di leopardo. Ora potrà finalmente diventare realtà, sempre che i servizi siano erogati in modo equo in tutto il territorio, a cominciare dalla telemedicina. Ne abbiamo discusso con l’avvocata Silvia Stefanelli, esperta di diritto sanitario e sanità digitale.

La rete delle cure palliative in Italia è ben normata, ma non ancora realizzata in tutti i territori, che si dovranno adeguare entro il 2024. Ne raccontano l’evoluzione Gino Gobber e Italo Penco (Società italiana di cure palliative) e Arturo Cuomo (Progetto Relief Campania)

Risultati positivi dalla Nota che amplia agli mmg la prescrizione di anticoagulanti orali diretti per i soli pazienti con fibrillazione atriale non valvolare. Un percorso che coinvolge sempre di più il territorio e la medicina generale nella presa in carico di pazienti cronici.

Comunicato del 12/10/2021 n°67

Comunicato del 27/09/2021 n°61