Explore the vast range of titles available.

Background: Anti-glaucoma eye drops have been investigated due to their production of fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. We aimed to assess whether these effects may impair the effectiveness of endoscopic endonasal dacryocystorhinostomy (EE-DCR). Methods: This is a single-center observational retrospective study on EE-DCR via a posterior approach. Resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Results: Twenty patients (32 sides) were enrolled. Preoperatively, 93.75% (n = 30/32) presented severe (Munk 3–4) epiphora and 68.75% (n = 22/32) recurrent dacryocystitis. At T1, 50.0% (n = 16/32) were referred with residual epiphora (Munk ≥ 1) and 18.75% (n = 6/32) dacryocystitis. At T2, 31.25% (n = 10/32) still complained of epiphora (Munk ≥ 1) and 6.25% (n = 2/32) dacryocystitis. Difference of outcomes at aggregate and paired timepoints (except for T1 versus T2) resulted in statistical significance (p < 0.05). At T2, 22 (68.75%) complete, 8 (25.0%) anatomical successes and 2 (6.25%) surgical failures were observed. Conclusions: Despite the chronic uptake of anti-glaucoma eye drops, EE-DCR guaranteed high rates of clinical relief from epiphora and remarkable decreases in the rates of recurrent dacryocystitis.

Several factors that underlie health inequality have been studied and defined as the social determinants of health (SDHs). The main SDHs are gender, socioeconomic status (SES), and ethnicity. In this study, disparity was analyzed in the context of vascular diseases (VDs) such as Peripheral Artery Disease (PAD), Chronic Venous Disease (CVD), Abdominal Arterial Aneurysm (AAA), and Carotid Stenosis (CS). This article aims to provide a comprehensive overview of the published evidence of the SDHs in VDs. For this purpose, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Published articles using the Scopus and ScienceDirect databases were searched. The criteria for the articles’ inclusion/exclusion were decided using a modified PICOTS framework. For the selected articles, the data sheets were organized in such a way to extract all data of potential relevance. Our findings showed that in VDs, gender, SES, and ethnicity are very important, with some specific problems for VDs analyzed. In conclusion, having detected the presence of SDHs that act negatively on VDs, a model based on action items for the SDHs associated with VDs was proposed.

Chronic kidney disease (CKD) is a clinical condition characterized by high morbidity and mortality. Globally, CKD is also increasing in prevalence and incidence. The two principal kidney measures namely estimated glomerular filtration rate (eGFR) and albuminuria have been found to be predictors of renal and cardiovascular (CV) endpoints including peripheral artery disease (PAD). The prevalence of PAD was increased in CKD patients and, particularly, in patients with more severe CKD stages. Despite the fact that revascularization strategies are suitable in CKD patients in similar fashion to non-CKD patients, few CKD patients underwent these procedures. In fact, if it is true that revascularization improves prognosis in PAD patients irrespective of baseline eGFR, it was also demonstrated that CKD patients, who underwent revascularization, were at higher risk for amputations, mortality, reintervention and perioperative complications. With the present review article, we have examined the association between CKD, PAD and peripheral revascularization highlighting data about epidemiology, pathophysiologic mechanisms, and results from previous observational and intervention studies. We have also examined the future perspectives and challenges of research around the association between CKD and PAD. Keywords: chronic kidney disease, CKD, peripheral artery disease, PAD, ESKD, amputations, albuminuria

Enhancement of information transfer has been proposed as a key driver of the evolution of coloniality. Transfer of information on location of food resources implies that individuals from the same colony share foraging areas and that each colony can be associated to a specific foraging area. In colonial breeding vertebrates, colony-specific foraging areas are often spatially segregated, mitigating intercolony intraspecific competition. By means of simultaneous GPS tracking of lesser kestrels ( Falco naumanni ) from neighbouring colonies, we showed a clear segregation of space use between individuals from different colonies. Foraging birds from different neighbouring colonies had home ranges that were significantly more segregated in space than expected by chance. This was the case both between large and between small neighbouring colonies. To our knowledge, the lesser kestrel is the only terrestrial species where evidence of spatial segregation of home ranges between conspecifics from neighbouring colonies has been demonstrated. The observed spatial segregation pattern is consistent with the occurrence of public information transfer about foraging areas and with the avoidance of overexploited areas located between neighbouring colonies. Our findings support the idea that spatial segregation of exploited areas may be widespread among colonial avian taxa, irrespective of colony size.

Background. Workplace violence (WPV) is a major healthcare problem with important consequences in healthcare areas and may impact negatively not only healthcare workers but also the quality and safety of patient care. Objectives: This an observational online web-based survey using Google® Modules, specifically aiming to investigate the phenomenon of WPV in Italian healthcare services. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 May 2021 to 31 May 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison between groups was assessed by unpaired t-test or Mann–Whitney U test according to variable distribution. Categorical variables were analyzed using the chi-squared test. Results. The study population consisted of 203 healthcare workers, represented by nurses (61.6%), medical doctors (16.8%), patient care assistants (4.9%), and others (16.7%). Female gender was associated with a 2.6 times higher risk for the presence of aggression (p = 0.034), and nurse as a job with about 4 times increased risk for the presence of aggression (p = 0.006). The risk for aggression increased by 5% for each year of work experience. Conclusions. WPV is still matter of concern in Italian healthcare services. A strong organizational effort is demanded from healthcare institutions in order prevent internal and external violence in healthcare settings.

Wounds are a major public health challenge for nurses, and poor wound care has important implications for patients and health care systems. The aim of this study is to assess the Italian registered nurses’ (RNs) perception in the area of wound care, regarding their knowledge, tasks of care delivery, wound management, values, and attitudes, exploring also the previous specific education received during nursing education. An observational online web-based survey was used to assess learning goals and content for wound care education in undergraduate nursing education and the skills and level of self-efficacy in this area during clinical practice. The data were collected between April and May 2022. A total of 210 RNs were interviewed and divided into five national geographic areas. Northwestern RNs showed a better education about the wound care area during university courses: the rate of RNs that did not receive any training in the wound care area was lower than in other Italian geographical areas. Southern RNs presented a better knowledge about factors that expose the wound to becoming chronic, wound drains care, and the ability to assess diabetic foot. This study showed that, in Italy, education in wound care among nursing students is relatively poor, and many skills are achieved during an RN’s career in an empirical way.

Aim: Migratory animals regularly move between often distant breeding and non‐breeding ranges. Knowledge about how these ranges are linked by movements of individuals from different populations is crucial for unravelling temporal variability in population spatial structuring and for identifying environmental drivers of population dynamics acting at different spatio‐temporal scales. We performed a large‐scale individual‐based migration tracking study of an Afro‐Palaearctic migratory raptor, to determine the patterns of migratory connectivity of European breeding populations. Location: Europe, Africa. Methods: Migration data were recorded using different devices (geolocators, satellite transmitters, Global Positioning System dataloggers) from 87 individuals breeding in the three core European populations, located in the Iberian, Italian and Balkan peninsulas. We estimated connectivity by the Mantel correlation coefficient (rM), and computed both the degree of separation between the non‐breeding areas of individuals from the same population (i.e. the population spread) and the relative size of the non‐breeding range (i.e. the non‐breeding range spread). Results: European lesser kestrels migrated on a broad front across the Mediterranean Sea and Sahara Desert, with different populations using different routes. Iberian birds migrated to western Sahel (Senegal, Mauritania, western Mali), Balkan birds migrated chiefly to central‐eastern Sahel (Niger, Nigeria, Chad), whereas Italian ones spread from eastern Mali to Nigeria. Spatial differentiation of non‐breeding areas led to a strong migratory connectivity (rM = .58), associated with a relatively high population (637 km) and non‐breeding range (1,149 km) spread. Main conclusions: Our comprehensive analysis of the non‐breeding distribution of European lesser kestrel populations revealed a strong migratory connectivity, a rare occurrence in long‐distance avian migrants. The geographical conformation of the species’ breeding and non‐breeding ranges, together with broad‐front migration across ecological barriers, promoted the differentiation of migratory routes and non‐breeding areas. Strong connectivity could then arise because of both high population spread and broad non‐breeding range.

Introduction: Anaphylaxis is one of the most frequent and misdiagnosed emergencies in the pediatric emergency department (PED). We aimed to assess which factors play a major role for a correct diagnosis and an appropriate therapy. Methods: We reviewed the records of children discharged with a diagnosis of anaphylaxis or an allergic reaction over 11 years from 3 hospitals in the Bologna city area. Results: One hundred and sixteen cases matched the criteria (0.03% of the total admittances) and were divided according to the patients’ symptoms at arrival: active acute patients [AP], n = 50, or non-acute patients ([NAP], n = 66). At the patients’ discharge, anaphylaxis was diagnosed in 39 patients (33.6%). Some features seemed to favor a correct diagnosis: active symptoms at arrival (AP vs. NAP, p < 0.01), high-priority triage code (p < 0.01), and upper airway involvement (p < 0.01). Only 14 patients (12.1%), all in the AP group, received epinephrine, that was more likely administered to patients recognized to have anaphylaxis (p < 0.01) and with cardiovascular, respiratory, or persistent gastrointestinal symptoms (p < 0.02), as confirmed by logistic regression analysis. Conclusions: Anaphylaxis is still under-recognized and under-treated. Correct triage coding and a proper diagnosis seem to foster an appropriate treatment. Physicians often prefer third-line interventions. Specific training for nurses and physicians might improve the management of this disease.

Background. Insomnia is one of the major health problems related with a decrease in quality of life (QOL) and also in poor functioning in night-shift nurses, that also may negatively affect patients’ care. The aim of this study is to evaluate the prevalence of insomnia in night shift nurses. This observational online web-based survey using Google®® modules specifically aimed to investigate the prevalence and risk factors for insomnia among Italian nurses. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 March 2021 to 1 April 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison among insomnia categories was assessed by one-way ANOVA or Kruskal–Wallis test according to variable distribution. Categorical variables were analyzed using chi-square test. Results. A total of 2355 responses were included in the final analysis, with 917 from the Northern zone, 815 from the Western zone, and 623 from the Southern zone of Italy. The prevalence of insomnia in the overall population was 65.4% (1524 out 2355 nurses suffered from insomnia). Conclusions. Nursing is a high-pressure profession, with heavy duties and high professional risks. We found an important prevalence of insomnia in night shift nurses, and we hope it may help to solicit further studies aimed to identify the risk factors for this working disorder among nurses.

Background: Venous return in the circulatory system of lower limbs results from the interaction of several mechanisms and reflects the balance between blood inflow and outflow. Blood outflow improves during the lying position especially with leg elevation both in patients with chronic venous disease (CVD) and in healthy subjects in sedentary settings with short-term immobilization. This study evaluated the level of comfort of hospital inpatients, without CVD, lying with a moderate leg elevation during hospital stay. Methods: This was a clinical trial examining 60 consecutive patients referred to vascular surgery, cardiac surgery, and nephrology units. After inclusion, patients were randomly assigned to two groups: A (leg elevation) in which patients were made to lie in the hospital bed with moderate elevation of the legs, and B (no leg elevation) in which patients were made to lie in the hospital bed without leg elevation. Results: The whole population consisted of 40 patients undergoing leg elevation (group A) and 20 without leg elevation (group B). During each day of hospitalization, measurements such as ankle and calf circumference, heart rate, blood pressure, and body temperature were collected. Subjective data such as perceived heaviness in the lower limbs, comfort perception and hours of sleep were also collected. In this study, patients of group A recorded a decrease in calf and ankle circumference (delta in ankle and calf circumference (difference between end of study visit and baseline visit) were significantly decreased in group A vs group B (p<0.001 for both sides), and patients perceived less leg heaviness and even reported more leg comfort compared to patients of Group B (p<0.001)). Among patients of group A, the bigger advantage in terms of comfort perception was recorded in patients with 15[degrees] leg elevation. Conclusion: Moderate leg elevation during hospital stay seems to effectively improve leg comfort in hospitalized patients. Keywords: venous system, lower limb, circulation, leg elevation, hospital stay, vein symptoms, leg discomfort