Health Literacy of Oncologic Patients and Their Informal Caregivers

The haemato-oncological patient requires care due to the impact of the disease itself as well as the hard treatment. Health professionals and informal caregivers also play a central role in this multipart and demanding process of caring and management of the disease. Communication and health literacy to the patients and respective caregivers are crucial in promoting safe care. The development of quality improvement projects by health organizations has contributed to increase health literacy among its participants. Its implementation contributes to a closer relationship between health professionals, patients, and informal caregivers with a consequent improvement in the response to their needs.

Virtual Reality Environments in Pain Management

Pain is a distressing and subjective feeling that occurs in different intensities and may result from the stimulation of a nerve due to injury, illness, or emotional disturbance. This chapter aims to understand how VR can contribute to pain management. To this end, the authors will address topics such as: pain – types of pain and its consequences in everyday life, as well as ways to relieve it; virtual reality – what it consists of, its functionalities and components, as well as its application to health and well-being, its advantages and limitations; and virtual reality in pain management. It is intended to emphasize the importance of pain management for the daily lives of individuals and the consequent improvement in the quality of life of those who benefit from this type of intervention.

Emilia-Romagna Regional Blood System accreditation as an example of improvement through application of specific requirements: a retrospective analysis

BackgroundInstitutional accreditation in Italy represents the license given by a region to a public or private facility to provide services in the name and on behalf of the National Health Service. This study aims to evaluate the improvement of the Emilia-Romagna Regional Blood System and to highlight its unresolved issues, analysing non-conformities observed during accreditation and maintenance inspections between 2013 and 2018.MethodsAll the Emilia-Romagna Regional Blood facilities were invited to participate in this study voluntarily and anonymously. Participants had to access a web application that we developed specifically. For each of the three inspections evaluated in this study, they had to enter data about the state of their organisation branches and non-conformities observed by regional inspectors. All data entered were finally exported from the web application database and analysed with spreadsheets. Statistical analysis was performed using Wilcoxon signed-rank test with continuity correction.Results17 structures took part in the study, with a total of 174 organisation branches. The number of branches changed over the years because of new openings and closures due to reorganisations or non-conformities that were too difficult to correct. Inspectors observed 2381 non-conformities (291 structural, 611 technological and 1479 organisational). As a result of accreditation inspections and consequent improvement actions, non-conformities were reduced by 88%. The most frequent non-conformities concerned the management software and the transportation of blood and blood components.ConclusionAn improvement in the Emilia-Romagna Regional Blood System over time is evident: institutional accreditation certainly pushed it to change and overcome its problems to comply with specific requirements. The remaining non-conformities after the three inspections were mostly organisational and management software was the most critical issue. Despite these non-conformities, all currently active structures are accredited and guarantee high standards of quality and safety of products and services.

Distance learning in medical education: an integrative review

Distance Education (DE) is a teaching modality established with the purpose of expanding the possibilities of access to education, promoting a democratization of access to knowledge. The objective of the work was to analyze the impact of telemedicine during medical training. The methodology was an integrative literature review to answer the PICO strategy (P: medical students; I: distance education; C: face-to-face education; O: telemedicine as a harmful factor): Can Telemedicine be harmful to medical training?It was observed that 90% of the students agreed that this methodology was motivating, and that it favored the active participation of the students. Distance education, when systematized and well applied, allows for greater interaction, improvement of knowledge in a flexible environment, with a consequent improvement in the quality of learning, however it should not aim to replace the traditional medical teaching model, much less when it comes to practical content.Keywords: education, education distance, medicine, students medical, telemedicine.

Bronchial hygiene technique in patients with cystic fibrosis

Cystic Fibrosis is characterized by excess pulmonary secretions that cause recurrent respiratory infections, with consequent deterioration of gas exchange. Bronchial hygiene techniques aim to mobilize secretions from the peripheral airways so that they can be eliminated by coughing or tracheal aspiration. To identify the effects of different bronchial hygiene techniques on improving lung function in patients with Cystic Fibrosis. Through a systematic review of the literature, randomized controlled trials (RCTs) published between 2007 and 2021 were selected, according to the highest score in the PEDro score. The search involved the PEDro and PubMed databases, using the following keywords: bronchial hygiene. Six ECR`s were included. One study performedthe techniques during anesthesia and observed increased resistance and reduced compliance. Regarding FEV1, 3 RCTs with hospitalized patients showed improvement in lung function, regardless of the technique used. In outpatients, there was no improvement. Regarding secretion weight, the cough machine produced more secretion than autogenous drainage, as well as a drop in saturation after the 2-min walk test, and increased FEV1. Bronchial hygiene techniques in patients with cystic fibrosis have been shown to be effective in removing mucus, with consequent improvement in lung function and aerobic fitness.

Automated Detection and Removal of Cardiac and Pulse Interferences from Neonatal EEG Signals

Electrical cardiac and pulsatile interference is very difficult to remove from electroencephalographic (EEG) signals, especially if recorded in neonates, for which a small number of EEG channels is used. Several methods were proposed, including Blind Source Separation (BSS) methods that required the use of artificial cardiac-related signals to improve the separation of artefactual components. To optimize the separation of cardiac-related artefactual components, we propose a method based on Independent Component Analysis (ICA) that exploits specific features of the real electrocardiographic (ECG) signals that were simultaneously recorded with the neonatal EEG. A total of forty EEG segments from 19-channel neonatal EEG recordings with and without seizures were used to test and validate the performance of our method. We observed a significant reduction in the number of independent components (ICs) containing cardiac-related interferences, with a consequent improvement in the automated classification of the separated ICs. The comparison with the expert labeling of the ICs separately containing electrical cardiac and pulsatile interference led to an accuracy = 0.99, a false omission rate = 0.01 and a sensitivity = 0.93, outperforming existing methods. Furthermore, we verified that true brain activity was preserved in neonatal EEG signals reconstructed after the removal of artefactual ICs, demonstrating the effectiveness of our method and its safe applicability in a clinical context.

Análisis de las variables cinemáticas en la técnica del pateo en el fútbol a partir de criterios de eficiencia biomecánicos

La presente investigación se realizó con el objetivo de analizar las variables cinemáticas que se manifiestan en la técnica del pateo en el fútbol a partir de criterios de eficiencia biomecánicos. Fue una investigación de nivel descriptivo, con un diseño de campo, basado en un estudio de caso con una atleta de 15 años. Se utilizó el método videográfico tridimensional (3D) con los enfoques: cuantitativo (programa “Human v 5.0”) y cualitativo (escala Likert). Se cuantificaron las variables cinemáticas mediante pre y pos test. Se establecieron criterios de eficiencia para optimizar variables biomecánicas en las fases: Preparatoria y Pateo. Así, se orientó el entrenamiento de la adolescente en función de fortalezas y debilidades identificadas desde la perspectiva biomecánica, lo que permitió optimizar la técnica de los miembros inferiores, dominante y no dominante. Entre otros resultados, destacó el aumento de sincronización y consecuente mejoría del patrón temporal de movimiento lo que facilitó la coordinación de impulso parcial, y por ende la transferencia de energía del cuerpo hacia el balón, incidiendo positivamente en la velocidad resultante, trayectoria y precisión del balón con lo cual aumentó la frecuencia del gol, hecho que incidió en el rendimiento y perfil de la joven, destacándose en la posición lateral con un manejo eficiente del balón por ambos perfiles. The present investigation was carried out with the objective of analyzing the kinematic variables that are manifested in the kicking technique in soccer based on biomechanical efficiency criteria. It was a descriptive level investigation, with a field design, based on a case study with a 15-year-old athlete. The three-dimensional (3D) videographic method was used with the approaches: quantitative (“Human v 5.0” program) and qualitative (Likert scale). Kinematic variables were quantified by pre and posttest. Efficiency criteria were established to optimize biomechanical variables in the phases: Preparatory and Kicking. Thus, the adolescent's training was oriented according to the strengths and weaknesses identified from the biomechanical perspective, which allowed optimizing the technique of the dominant and non-dominant lower limbs. Among other results, the increase in synchronization and consequent improvement in the temporal pattern of movement stood out, which facilitated the coordination of partial impulse, and therefore the transfer of energy from the body to the ball, positively influencing the resulting speed, trajectory and precision of the ball which increased the frequency of the goal, a fact that affected the performance and profile of the young woman, standing out in the lateral position with an efficient handling of the ball by both profile.

Structural Health Monitoring of Electro-Mechanical Actuators in Aviation: Recent Breakthroughs and Further Challenges

Electrical actuation systems have recently been introduced in aviation pursuing the concepts of More Electric Aircraft. Instead of employing hydraulic pipelines, Electro-Mechanical Actuator (EMA) transfers the power by “wires” with a consequent improvement of the aircraft actuation performance. However, the integration of linear electromechanical actuators is promising yet challenging in safety critical systems. Within this context, this work critically reviews electromechanical actuators currently available for aerospace application, the limits for their upcoming deployment and the different solutions to achieve an on-condition maintenance to reduce any safety risk during lifetime. First of all, the typical conversion mechanism adopted so far are briefly described with emphasis on the most suited for aerospace applications. A further insight is given to failure modes of these systems, which dramatically contrast the countless inherent advantages thereof. A particular attention is given to the jamming of the driven load, which is a critical mechanical transmission failure in many applications such as primary flight controls or landing gears extension and steering. Finally, the focus is moved to possible strategies to avoid any hazard induced by this failure. In particular, any structural alteration which is prone to induce jamming can be monitored towards the establishment of a predictive maintenance. Different possibilities are available in the way to timely assess the bearing of inner EMA surfaces where screwing is enabled.

Evaluation of a program for promoting physical activity and well-being: Friuli Venezia Giulia in Movimento

This article presents an evaluation of the “Friuli Venezia Giulia in Movimento” project, aimed at promoting the culture of movement and well-being in a region which is particularly affected by population ageing. The goals of the project reside in promoting appropriate lifestyles through the endorsement of healthy behaviours (physical activity, healthy nutrition, well-being); increasing the number of physically active people in the various municipal territories, by enhancing or creating new pedestrian paths that reflect the 10,000-step goal; enhancing the local territory by promoting the existing paths and the initiatives already in place; promoting new paths and environments conducive to physical activity for people of all ages; encouraging the creation of new “walking groups” and the adhesion of people to them to promote physical activity and socialisation, with the consequent improvement of psychophysical well-being. Although the evaluation is still on-going, the preliminary results—obtained by means of two surveys and a multilevel model—show that the initial steps of the project have been carried out satisfactorily and that Municipalities still need to be supported in order to achieve good participation on part of the citizens.

Health needs related to chemotherapy treatment: construction and validation of educational videos

Objective: to construct and validate the content of educational videos on health needs related to chemotherapy treatment. Methods: methodological study, carried out in four stages: identification of the health needs of patients on chemotherapy; construction of the educational videos; validation by expert judges; and adequacy. Results: health needs were identified and based on these, three educational videos were constructed with content validated by 31 to 35 judges, depending on the content of each one. The total Content Validity Index and the items of the evaluation criteria were higher than 0.80 and all items had a 95% confidence interval, whose lower limit was also higher than 0.80. Subsequently, the suggested adaptations were made to improve and confer legitimacy to the videos. Conclusion: the videos are believed to contribute to the patients’ knowledge and self-management of symptoms at home, adaptation to treatment, and consequent improvement in quality of life.