Risultati per: La qualità dei nutraceutici e position paper per l’appropriato uso in medicina generale

Objectives
To map the current use of paper-based and/or screen-based media for health education aimed at older people.

Design
A scoping review was reported following the Preferred Reporting Items of Systematic Reviews and Meta-analyses for Scoping Reviews checklist.

Data sources
The search was carried out in seven databases (Scopus, Web of Science, Embase, Medline, CINAHL, ACM Guide to Computing Literature, PsycINFO), with studies available from 2012 to the date of the search in 2022, in English, Portuguese, Italian or Spanish. In addition, Google Scholar was searched to check the grey literature. The terms used in the search strategy were older adults, health education, paper and screen-based media, preferences, intervention and other related terms.

Eligibility criteria
Studies included were those that carried out health education interventions for older individuals using paper and/or screen-based media and that described barriers and/or facilitators to using these media.

Data extraction and synthesis
The selection of studies was carried out by two reviewers. A data extraction form was developed with the aim of extracting and recording the main information from the studies. Data were analysed descriptively using Bardin’s content analysis.

Results
The review included 21 studies that carried out health education interventions with different purposes, the main ones being promotion of physical activity, hypertension prevention and psychological health. All 21 interventions involved screen-based media on computers, tablets, smartphones and laptops, while only 4 involved paper-based media such as booklets, brochures, diaries, flyers and drawings. This appears to reflect a transition from paper to screen-based media for health education for the older population, in research if not in practice. However, analysis of facilitators and barriers to using both media revealed 10 design factors that could improve or reduce their use, and complementarity in their application to each media type. For example, screen-based media could have multimedia content, additional functionality and interactivity through good interaction design, but have low accessibility and require additional learning due to complex interface design. Conversely, paper-based media had static content and low functionality but high accessibility and availability and a low learning cost.

Conclusions
We recommend having improved screen-based media design, continued use of paper-based media and the possible combination of both media through the new augmented paper technology.

Registration number
Open Science Framework (DOI: 10.17605/OSF.IO/GKEAH).

To the Editor The PRONECMO study on the effects of prone positioning during ECMO concluded that prone positioning did not significantly reduce the time to successful weaning of ECMO. However, we find the presentation of this conclusion unclear.

In Reply In their Letter about our recent study, Drs Wiener and Albert suggest that incorporating periodic sigh breaths into ultraprotective lung ventilation during ECMO could potentially enhance the efficacy of prone positioning. They suggest that this approach may help expand atelectatic regions, improve lung compliance, reduce cyclical airspace opening and closing, and subsequently facilitate earlier ECMO weaning. While we acknowledge the potential appeal of this mechanical ventilation strategy, the literature currently lacks data on the utilization of periodic sigh breaths in conjunction with very low tidal volume, reduced driving pressure (ie, plateau pressure minus positive end-expiratory pressure), and respiratory rate. Physiological investigations and randomized clinical trials have primarily focused on patients with tidal volume exceeding 6 mL/kg of predicted body weight and moderately impaired lung compliance. This area warrants further exploration, particularly regarding the determination of safe plateau pressure and the duration and interval of periodic sigh breaths in patients with profoundly reduced respiratory system compliance and normalized gas exchanges (oxygenation and decarboxylation provided by ECMO).

To the Editor Use of prone ventilation in patients with acute respiratory distress syndrome (ARDS) decreases pulmonary arterial to venous shunt, improves respiratory system compliance, and reduces cyclical airspace opening/closing in dependent lung regions. In their randomized clinical trial of prone positioning in conjunction with extracorporeal membrane oxygenation (ECMO), Dr Schmidt and colleagues used ultraprotective lung ventilation (tidal volume ≤4 mL/kg) to achieve low airspace opening pressures. There were no attempts to vary either the tidal volume or the level of positive end-expiratory pressure to optimize respiratory system compliance in either posture (prone vs supine positioning). The low tidal volumes used would limit the extent to which ventilation in the prone position could open atelectatic areas, increase compliance, and improve ventilation, possibly accounting for their finding that prone positioning did not facilitate earlier weaning from ECMO. The low tidal volumes administered without use of periodic sigh breaths (ie, large inflations to or approaching total lung capacity) could also account for the frequent development of whole lung atelectasis that they observed, and this would further limit the ability of prone ventilation to reduce cyclical airspace opening and closing and time to weaning from ECMO.

Serve un sistema che integri i dati che arrivano da varie fonti

Comunicato del 22/03/2024 n°17

La conferma potrebbe arrivare in coincidenza con la festa della donna, il prossimo 8 marzo, quando il ministro della Salute Schillaci potrebbe svelarne il nome

Oggi c’è carenza di medici per la cattiva programmazione e il picco dei pensionamentiDal 2034 in poi crollano le uscite e la maxi offerta di nuovi dottori può trasformarsi in una pletora

Progetto di ricerca italo-svizzero ‘Brain Spine Interface’

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Objectives
Current mental health practices for people living in residential aged care (RAC) facilities are poor. In Australia, there are no mechanisms to monitor and promote mental health for people living in RAC, including those who experience changed behaviours and psychological symptoms. The aim of this study is to improve current practices and mental health outcomes for people living in RAC facilities by codesigning a Mental Health benchmarking Industry Tool for residential aged Care (MHICare Tool).

Methods
A two-stage sequential and mixed methods codesign methodology will be used. Stage 1 will include qualitative interviews and focus groups to engage with residents, family/care partners and RAC staff to ascertain mental healthcare practices and outcomes of greatest significance to them. Adapted concept mapping methods will be used to rank identified issues of concern in order of importance and changeability, and to generate draft quality indicators. Stage 2 will comprise a Delphi procedure to gain the wider consensus of expert panel views (aged care industry, academic, clinical) on the performance indicators to be included, resulting in the codesigned MHICare Tool.

Ethics and dissemination
This study has been reviewed and approved by the University of Queensland Human Research Ethics Committee (HREC/2019002096). This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). The study’s findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.

Conclusion
This protocol reports structured methods to codesign and develop a mental health performance indicator tool for use in Australian RAC.

Morto a 92 anni per i postumi di un incidente a Forlì

Si occuperà dei piani di indirizzo e gestione dell’associazione