Search Results (12)

Staff attitudes towards the sexuality of adults with mild intellectual and developmental disabilities may influence how the sexuality of service users is dealt with. The present study aimed to examine these attitudes in a Spanish context. A total of 102 staff members from service facilities for adults with intellectual and developmental disabilities, including direct-care and professional staff, responded to an online version of the Attitudes Towards the Sexuality of Individuals with Intellectual Disabilities Scale. In general, the participants demonstrated an understanding that adults with intellectual and developmental disabilities have sexuality. They reported favourable attitudes towards some self- and other-oriented sexual behaviours and sex education. Intermediate scores and variability on some items revealed concerns about these adults’ ability to control their sexual urges, perceptions of sexual abuse, pornography use, and contraception. Some differences appeared in relation to socio-demographic variables, experience and job position. Although generally favourable, differences in dispositional attitudes, such as talking about sexuality, were related to years of experience in the field. Professional staff reported greater acceptance of some sexual behaviours compared to direct-care staff. These findings are relevant to understanding variability in staff perceptions. The need for support to respond to service users’ sexuality, especially among direct-care professionals, is discussed. Full article

Introduction: Since the COVID-19 pandemic, the Italian National Health Service (NHS) has been undergoing a structural reform shifting focus from hospital-centered care to smaller, intermediate, or primary health facilities closer to the community (e.g., community hospitals and community houses). This reorganization should include rehabilitation and physiotherapy, but the actual spread of these services is still unclear. Objective: This study explored the number and characteristics of community-based physiotherapy services in the Metropolitan City of Milan (Italy). Methods: Between April and May 2024, we distributed a structured, anonymous online survey about community physiotherapy services and users to all Directors of the Health and Social Care Professions Departments (DAPSS) in the Metropolitan City of Milan. We used descriptive statistics to analyze the number of community houses offering physiotherapy services, the specific intervention areas, and access modalities. Results: Six out of seven DAPSS Directors completed the survey (87%). Thirty-seven community houses were reported in the area, with fourteen of these offering physiotherapy services. In most of them, physiotherapy was a primary reason for access following a general practitioner’s prescription. Five out of six responders reported that rehabilitation needs were mainly assessed by specialists in Physical and Rehabilitation Medicine, with physiotherapists involved in the assessment process in two cases. Physiotherapists primarily handled the intervention phase, dealing mainly with orthopedic and neurological conditions. DAPSS Directors noted that additional physiotherapy initiatives focusing on prevention will be implemented. Conclusions: Physiotherapy services are becoming available in the Metropolitan City of Milan. However, more efforts are needed to facilitate access and ensure tailored assessment and effective interventions, particularly in preventive care. Future investigations should help to better define the number and the characteristics of the patients who can most benefit from this type of care, the number of sessions they need, and with what types of intervention; it would be also necessary to better define the communication network in the area that allows doctors, health professionals, and patients to be informed about this possibility. Full article

Hospitals have demonstrated their enormous capacity to adapt to the rapidly changing situation imposed by the pandemic: increasing the number of intensive care units and intermediate and inpatient beds, with the corresponding human resources, services and facilities required. Internationally, the enormous demand to manage the COVID-19 pandemic has challenged hospitals in terms of staffing, supplies and equipment. This article analyses the effect of the COVID-19 pandemic on hospital activities, from the perspective of its environmental impact. It compares a year of normal hospital activities, 2019, with data on hospital activities from 2020. The aim of this research is to analyse the changes produced by the pandemic in the regular activities of the hospital and to determine the environmental impact, which allows reflecting on the exceptional situation generated. The results show that the hospital’s environmental impact increased significantly in 2020 compared to 2019, with a 17.2% increase in overall environmental efficiency indices. The main contributors to this increase were waste generation and medical gas consumption, which are critical aspects of hospital activities during the pandemic. Full article

Intermediate care units (IMCUs) have become increasingly important in the care of critical and semi-critical patients, particularly during the COVID-19 pandemic. However, there is still no clear definition of their structural characteristics, specialties, types of patients, and the benefits they provide. The aim of this work is to describe the current state of implementation and operation of IMCUs in hospitals and patient care. To achieve this goal, a systematic review was conducted in the Web of Science, Scopus and CINAHL databases, along with a hand search. The research yielded 419 documents, of which 26 were included in this review after applying inclusion and exclusion criteria. The results were highly diverse and were categorized based on the following topics: material resources, human resources, continuity of care, and patient benefits. Despite the different objectives outlined in the studies, all of them demonstrate the numerous benefits provided by an IMCU, along with the increased relevance of this type of unit in recent years. Therefore, this systematic review highlights the benefits of IMCUs in the care of critical patients, as well as the role of health workers in these units. Full article

The last decade was characterized by the reduction in hospital beds throughout Europe. When facing the COVID pandemic, this has been an issue of major importance as hospitals were seriously overloaded with an unexpected growth in demand. The dichotomy formed by the scarcity of beds and the need for acute care was handled by the Bed Management (BM) function. This case study explores how BM was able to help the solidness of the healthcare system, managing hospital beds at best and recruiting others in different settings as intermediate care in a large Local Health Authority (LHA) in central Italy. Administrative data show how the provision of appropriate care was achieved by recruiting approximately 500 beds belonging to private healthcare facilities affiliated with the regional healthcare system and exercising the best BM function. The ability of the system to absorb the extra demand caused by COVID was made possible by using intermediate care beds, which were allowed to stretch the logistic boundaries of the hospitals, and by the promptness of Bed Management in converting beds into COVID beds and reconverting them, and by the timely management of internal patient logistics, thus creating space according to the healthcare demands. Full article

Bloodstream infections (BSI) are an increasing cause of admissions to hospitals. Non-hospital-acquired BSI are defined by blood cultures that are positive less than 48 hours after admission, but a relevant difference exists between community-acquired and healthcare-associated (HCA) BSI in terms of risk of multidrug resistance (MDR). We planned a retrospective study in three different cohorts in order to develop and to temporally and spatially validate an easy and rapid prognostic model for identifying MDR non-hospital-acquired (non-HA) BSI. The pathogens most involved in BSI are Staphylococcus spp. and Escherichia coli, responsible for about 75% of all MDR isolated. The model includes age, gender, long-term care facility admission, immunocompromise, any recent invasive procedures and central line placement, recent intravenous treatment and antibiotic treatment. It shows an acceptable performance, especially for intermediate probabilities of MDR infection, with a C-index of 70%. The model was proposed in a nomogram that could allow better targeting of antibiotic therapy for non-HA BSI admitted in hospital. However, it should be further validated to determine its applicability in other populations. Full article

Background: In contrast to alarming reports of exhaustion and burnout amongst healthcare workers in the first wave of the COVID-19 pandemic, we noticed surprisingly positive staff experiences of working in a COVID-19 field hospital in South Africa. The 862-bed “Hospital of Hope” was established at the Cape Town International Convention Centre specifically to cope with the effects of the first wave of the COVID-19 pandemic in Cape Town. Methods: We aimed to systematically describe and assess the effects on staff and the local health system. A cross-sectional descriptive study design was employed using mixed methods including record reviews and interviews with key informants. Results: Quantitative results confirmed high job satisfaction and low staff infection rates. The emerging themes from the qualitative data are grouped around a “bull’s eye” of the common purpose of person-centeredness, from both patient and staff perspectives, and include staff safety and support, rapid communication, continuous learning and adaptability, underpinned by excellent teamwork. The explanations for the positive feedback included good disaster planning, adequate resources, and an extraordinary responsiveness to the need. Conclusions: The “Hospital of Hope” staff experience produced valuable lessons for designing and managing routine health services outside of a disaster. The adaptability and responsiveness of the facility and its staff were largely a product of the unprecedented nature of the pandemic, but such approaches could benefit routine health services enormously, as individual hospitals and health facilities realize their place in a system that is “more than the sum of its parts”. Full article

The careful design of nanostructures and multi-compositions of non-noble metal-based electrocatalysts for highly efficient electrocatalytic hydrogen and oxygen evolution reaction (HER and OER) is of great significance to realize sustainable hydrogen release. Herein, bifunctional electrocatalysts of the three-dimensional (3D) cobalt-nickel phosphide nanoarray in situ grown on nickel foams (CoNiP NA/NF) were synthesized through a facile hydrothermal method followed by phosphorization. Due to the unique self-template nanoarray structure and tunable multicomponent system, the CoNiP NA/NF samples present exceptional activity and durability for HER and OER. The optimized sample of CoNiP NA/NF-2 afforded a current density of 10 mA cm⁻² at a low overpotential of 162 mV for HER and 499 mV for OER, corresponding with low Tafel slopes of 114.3 and 79.5 mV dec⁻¹, respectively. Density functional theory (DFT) calculations demonstrate that modulation active sites with appropriate electronic properties facilitate the interaction between the catalyst surface and intermediates, especially for the adsorption of absorbed H* and *OOH intermediates, resulting in an optimized energy barrier for HER and OER. The 3D nanoarray structure, with a large specific surface area and abundant ion channels, can enrich the electroactive sites and enhance mass transmission. This work provides novel strategies and insights for the design of robust non-precious metal catalysts. Full article

Antibiotic resistance toward commonly used medicinal drugs is a dangerously growing threat to our existence. Plants are naturally equipped with a spectrum of biomolecules and metabolites with important biological activities. These natural compounds constitute a treasure in the fight against multidrug-resistant microorganisms. The development of plant-based antimicrobials through green synthesis may deliver alternatives to common drugs. Lepidium sativum L. (LS) is widely available throughout the world as a fast-growing herb known as garden cress. LS seed oil is interesting due to its antimicrobial, antioxidant, and anti-inflammatory activities. Nanotechnology offers a plethora of applications in the health sector. Silver nanoparticles (AgNP) are used due to their antimicrobial properties. We combined LS and AgNP to prevent microbial resistance through plant-based synergistic mechanisms within the nanomaterial. AgNP were prepared by a facile one-pot synthesis through plant-biomolecules-induced reduction of silver nitrate via a green method. The phytochemicals in the aqueous LS extract act as reducing, capping, and stabilizing agents of AgNP. The composition of the LS-AgNP biohybrids was confirmed by analytical methods. Antimicrobial testing against 10 reference strains of pathogens exhibited excellent to intermediate antimicrobial activity. The bio-nanohybrid LS-AgNP has potential uses as a broad-spectrum microbicide, disinfectant, and wound care product. Full article

Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in older patients admitted to the ICFs. MPI was calculated using different domains explored by a standard comprehensive geriatric assessment and categorized into tertiles (MPI-1 ≤ 0.20, MPI-2 0.20–0.34, MPI-3 > 0.34). A Cox’s regression analysis, taking mortality as the outcome, was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). In total, 653 older patients were enrolled (mean age: 82 years, 59.1% females). Patients in MPI-2 (HR = 3.66; 95%CI: 2.45–5.47) and MPI-3 (HR = 6.22; 95%CI: 4.22–9.16) experienced a higher risk of mortality, compared to MPI-1. The accuracy of MPI in predicting mortality was good (area under the curve (AUC) = 0.74, 95%CI: 0.70–0.78). In conclusion, our study showed that prognostic stratification, as assessed by the MPI, was associated with a significantly different risk of mortality in older patients admitted to the ICFs, indicating the necessity of using a CGA-based tool for better managing older people in this setting as well. Full article

Background: To evaluate the potential factors associated with the nutritional composition of human milk of puerperal women. Methods: cross-sectional study, conducted between March 2016 and August 2017, with 107 women, selected in a Tertiary Health Care Tertiary Health Facility of the Unified Health System (SUS) in the Municipality of Rio de Janeiro. Data were collected two months after delivery. The dependent variable of the study was the nutritional composition of human milk. We divided the independent variables into hierarchical levels: distal (age, schooling, parity and pregestational nutritional status), intermediate (number of prenatal visits and gestational weight gain) and proximal (alcohol consumption, smoking, diabetes mellitus and hypertension). For data analysis, we applied the multiple linear regression, centered on the hierarchical model. Only the variables associated with the nutritional composition of breast milk remained in the final model at a 5% level of significance. Results: The nutritional composition of human milk yielded by women with pregestational overweight, smokers and hypertensive had higher amounts of lipids and energy. Conversely, women with gestational weight gain below the recommended had lower amounts of these components. Conclusion: The evaluation of factors associated with the nutritional composition of human milk is extremely important to assist post-partum care practices. In this study, we observed that lipid and energy contents were associated to pregestational nutritional status, gestational weight gain, smoking and hypertension. Full article

Understanding the sedentary patterns can guide the design of strategies to engage older adults in physical activity. This scoping review aimed to synthesize available evidence on sedentary behaviors in care facilities. We searched PubMed/MEDLINE and Web of Science for studies published from inception through October 2020. Eighteen studies were included and reviewed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data obtained were analyzed based on levels of care provided. Overall, daily sedentary time was higher among residents in high level care facilities (e.g., nursing homes) (11.6 h/day) than intermediate/mixed level care facilities (e.g., assisted living) (9.5 h/day). In intermediate/mixed level care facilities, television (TV) viewing was the most common sedentary activity (2.5–2.9 h/day; 26% of daily sedentary time), while napping was the most favorite sedentary activity (4.7 h/day; 36% of waking hours) in high level care facilities. Sex differences in daily patterns of sedentary behavior (sedentary time, uninterrupted bouts, and bout durations) were commonly observed in intermediate/mixed level care facilities, as exemplified by men being more sedentary by 0.7–1.1 h/day. In summary, this study highlights distinctive sedentary patterns among older adults residing in different levels of care facilities, addressing a pressing need for customized interventions to engage care facility residents in physical activity. Full article