Plastic cannulae versus metal needle cannulation in haemodialysis: Results of an international survey from the nurse perspective.

BACKGROUND: In haemodialysis is key to successfully obtaining cannulation of the arteriovenous fistula (AVF). The literature agrees that cannulation, failing in the initial maturation period, can lead to delayed dialysis, haematoma, scarring, needle phobia and loss of confidence in the cannulator. The introduction of plastic cannulae for haemodialysis has changed cannulation practice positively, preventing frequent complications such as infiltration or trauma. Despite that, most countries have continued to use metal cannulation, in particular in Europe. This study investigates the common use of plastic cannulae versus metal needles for cannulation in dialysis units and explores the implications of focusing on the side effects of cannulation. METHODS: The study is a cross-sectional survey. A questionnaire was created by a team of experts from the European Dialysis Transplant Nurse Association/European Renal Care Association (EDTNA/ERCA) to address the study's aims and sent online to nurse members. RESULTS: Data collected suggested a strong resistance towards using plastic cannulae, with few respondents claiming to use these cannulas. Most of the respondents were female (74%), Europeans, working in nephrology for more than 10 years and most worked in the public sector. There was a strong correlation between the use of plastic cannulae and fewer adverse events in elbow located AVF and newly created or fragile AVF. CONCLUSIONS: The results are in line with the current literature. Possible resistance to the use of the plastic device includes the difference in cost between the two devices in favour of metal needles. However, it should be considered that the lower number of adverse events, in particular infiltration and haematoma caused by the metal needle, involves a considerable saving both in money and in terms of time and distress for the patient.

The characteristics and activities of child and adolescent mental health services in Italy: a regional survey.

BACKGROUND: To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence.The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years. METHODS: Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail. RESULTS: Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years. CONCLUSION: The percentage of young people in contact with CAMHS for mental disorders is in line with those observed in previous epidemiological studies. The overall number of child psychiatrists per 100,000 inhabitants is one of the highest in Europe and it is comparable with the most well equipped areas in the US. This comparison should be interpreted with caution, however, because in Italy, child psychiatrists also treat neurological disorders. Critical areas requiring improvement are: the uneven utilisation of standardised assessment procedures and the limited availability of dedicated emergency services during non-office hours (e.g., nights and holidays).

Satisfaction with online teaching of medical statistics during the COVID-19 pandemic: A survey by the Education Committee of the Italian Society of Medical Statistics and Clinical Epidemiology.

On May 2020, after 2 months of online teaching with no face-to-face lectures, the Education Committee of the Italian scientific Society of Medical Statistics and Clinical Epidemiology conceived an online survey to assess satisfaction of Italian academics of medical statistics with online teaching and remote exams. This survey highlighted teachers' perceptions as well as opportunities and limitations of online teaching of medical statistics, biostatistics, and epidemiology. Although 61% of Italian academics of medical statistics declared to be favorable to provide online teaching of medical statistics, biostatistics, and epidemiology in the future, we recognize that distance education cannot substitute the unique value of teaching and knowledge exchange that could only be transmitted through a personal interaction between students and teachers. These indications may be useful to improve the quality of the teaching process in the future.