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Literature on the role of multidisciplinary team (MDT) in cancer is still controversial. We aimed to investigate MDT impact on a panel of indicators in breast cancer care in a single-center retrospective study performed in a Cancer Reference Center in Italy. We analysed the diagnostic and therapeutic care pathway (DTCP) of 266 early breast cancer patients managed by our MDT during 2019-2020. Process indicators reflecting the change of the diagnostic and therapeutic care pathways occurred after the MDT discussion were computed. Further, the performance of some quality care indicators in breast cancer care since the establishment of the MDT activity and the breast cancer MDT members' perceptions were also investigated. According to our study, the MDT approach improves breast cancer management by increasing the completion of staging and by encouraging neo-adjuvant treatment and an appropriate and faster surgery. In MDT members' perspective it also improves decision-making and training and creates a positive work environment. Globally, our study encourages MDT rollout in breast cancer care. However, to enhance the reliability and comparability of the results of studies investigating MDT effectiveness in clinical practice, shared guidelines on its operationalisation are strongly desirable.
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Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Procedimentos Clínicos , Estudos Retrospectivos , Reprodutibilidade dos Testes , Percepção , Equipe de Assistência ao PacienteRESUMO
Background: The aim of this project is to study the prevalence of cyberbullies (CB) and cybervictims (CV) and cyberbully-victims(CBV) in Italian adolescent students and a possible correlation with physical activity (PA) levels and as potential protective factor. Methods: The Italian version of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) was used for categorized cyberbullies (CB) and cybervictims (CV). Six items of the IPAQ-A Italian version were considered to measure the PA levels. Results: 2112 questionnaires were collected, with response rate of 80.5%. The sample reported 9% was CV only, 5% was CB only, and 6% was cyberbully-victims (CBV). The factors that are significant associated to the CV students were: female gender (OR=1.7; 95%CI:1.18-2.35); stay at middle school (OR=1.56; 95%CI:1.01-2.44); spent more than 2 hours on IT devices (OR=1.63; 95%CI:1.08-2.47). The variables significant associated to the CB students were: gender male (OR=0.51 95%CI:0.320.80); spent more than 2 hours on IT devices (OR=2.37; 95%CI:1.32-4.26); tobacco use (OR=2.55; 95%CI:1.63-3.98); an inverse proportion with the number of days spent in vigorous physical activities (OR=0.82; 95%CI:0.68-0.98). The CBV students were significant associated with a male gender (OR=0.58; 95%CI:0.38-0.89) and tobacco consumption (OR=2.22; 95%CI:1.46-3.37). Conclusions: The physical activity at vigorous level seem to be related to less involvement in cyberaggression, so it is recommended that those responsible for training adolescents' favour this aspect. Research on effective prevention is insufficient and evaluation of policy tools for cyberbullying intervention is a nascent research field an any prevention or intervention program could consider this factor.
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Bullying , Vítimas de Crime , Cyberbullying , Humanos , Masculino , Adolescente , Feminino , Estudos Transversais , Inquéritos e Questionários , InternetRESUMO
In this study, we surveyed the presence of personal protective equipment (PPE) waste on the streets of Bogotá-Colombia, Lima-Perú, and Mar del Plata-Argentina. Furthermore, this work is also focused on the release capacity of Ag, Cu, and Zn metals associated with nanoparticles, and microplastics (MPs) from textile face masks (TFMs) and disposable face masks. According to our results, an association between low-income areas and PPE waste was found, which may be related to the periodicity of waste collection and economic activity. Polymers, like polypropylene, cotton-polyester, and additives, such as CaCO3, MgO, and Ag/Cu as nanoparticles, were identified. TFMs released high levels of Cu (35,900-60,200 µg·L-1), Zn (2340-2380 µg·L-1), and MPs (4528-10,640 particles/piece). Metals associated with nanoparticles leached by face masks did not present any antimicrobial activity against P. aeruginosa. Our study suggests that TFMs may leach large amounts of polluting nano/micromaterials in aquatic environments with potential toxicological effects on organisms.
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Metais Pesados , Nanopartículas , Microplásticos , Máscaras , Plásticos , Cidades , Metais Pesados/análise , Equipamento de Proteção Individual , América do SulRESUMO
OBJECTIVES: Formaldehyde is an organic compound used in the production of resins, paper, wood plywood, solvents and cleaning products. Formaldehyde is also present when tobacco is smoked. Formaldehyde has been defined as an irritant and is classified as a human carcinogen by the International Agency for Research on Cancer. The purpose of this study was to demonstrate the following two distinct correlations: (1) the association between formaldehyde exposure and development of irritant diseases affecting the respiratory tract, mainly asthma; and (2) the association between formaldehyde exposure and development of neoplastic diseases. STUDY DESIGN: This was an umbrella review. METHODS: A search was conducted in the three main electronic databases of scientific literature: PubMed, Scopus and Web of Science. The search included systematic reviews and meta-analyses published in the previous 10 years. Initially, titles and abstracts of retrieved articles were evaluated, then full-text assessments of selected articles took place. Data extraction and quality assessment were performed according to Assessing the Methodological Quality of Systematic Reviews (AMSTAR) score. RESULTS: A total of 630 articles were initially collected. Nine articles concerning the association between formaldehyde exposure and asthma were included in the present review, and the majority of these reported good association. In addition, 27 articles investigating the association between formaldehyde exposure and neoplastic diseases were included in the review. These studies showed that nasopharyngeal cancer and leukaemia were the most represented neoplastic diseases; however, only a weak association was reported between formaldehyde exposure and cancer. CONCLUSIONS: Although the studies included in this review did not show a strong association between exposure to formaldehyde and irritant or neoplastic diseases, the World Health Organisation recommends that levels of formaldehyde do not exceed the threshold value of 0.1 mg/m3 (0.08 ppm) for a period of 30 min. It is recommended that preventive measures, such as ventilation in workplaces with high exposure to formaldehyde and environmental monitoring of formaldehyde concentrations, are implemented.
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Asma , Neoplasias Nasofaríngeas , Humanos , Irritantes/toxicidade , Revisões Sistemáticas como Assunto , Formaldeído/toxicidadeRESUMO
Abstract: Working night shifts has been associated with negative mental health consequences such as depression, anxiety, and sleep problems. The objectives of this study were to determine the lifestyle behaviors (prevalence of nicotine, caffeine, cannabis, sleep-promoting medication, and alcohol use) and the association between job stress, sleep quality, anxiety, and depression among registered nurses working night shifts in the Canadian province of Saskatchewan in the COVID-19 era. Twenty-two registered nurses ranging from ages 25-65 that work permanent or rotating night shifts participated in an online survey from April 11th to July 15th, 2022. The results showed a strong positive association between sleep disturbance, and depression r (19) = 0.50, [p = 0.029, 95% CI, 0.06, 0.78]. A positive correlation was found between higher levels of reported anxiety and sleep disturbance r (19) = 0.69, [p = 0.001, 95% CI, 0.34, 0.87]. There was a positive correlation between depression and occupational exhaustion r (17) = 0.56, [p = 0.021, 95% CI, 0.10, 0.82]. Anxiety was significantly related to occupational exhaustion r (17) = 0.65, [p = 0.005, 95% CI, 0.24, 0.86] and depersonalization r (17) = 0.52, [p = 0.005, 95% CI, 0.06, 0.80], but not significantly related to personal accomplishment r (17) = -0.34, [p = 0.185, 95% CI, -0.70, 0.17]. In conclusion, a sample of Canadian nurses working night shifts in the province of Saskatchewan during the COVID-19 pandemic showed a significant positive relationship among sleep disturbance, anxiety, and depression. Furthermore, most nurses reported using at least one or more of the following substances: sleep-promoting medication, nicotine, alcohol, and cannabis.
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COVID-19 , Enfermeiras e Enfermeiros , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Tolerância ao Trabalho Programado , Projetos Piloto , Nicotina , Pandemias , Canadá/epidemiologia , COVID-19/epidemiologia , Sono , Inquéritos e Questionários , Estilo de VidaRESUMO
Abstract: The present research focuses on the delicate and complex process of senilization of the population, being one of the most important anthropological and social problems of our time. These considerations lead us to examine not so much the aging process itself, but the relationship between the third age and society, focusing on the factors that promote or inhibit well-being and the relative perceptions that emerged in the sample. In this sense, an online questionnaire was administered, by email and by telephone message, over a period of approximately 10 months starting from March 2021 until December 2021. The questionnaire included multiple choice questions that produced clear data and simple analysis, arriving at an accurate analysis (qualitative and quantitative), on the topics of interest: the role of nutrition and sport in the over 65s, not only by the subjects in question, but also the considerations and perceptions of subjects belonging to different age groups with reference to the topics of interest relating to the third age. The sample results, allow us to identify the appropriate interven-tion strategies and policies useful for eradicating the stereotype that accompanied the concept of old age until a few years ago, making it synonymous with illness, loneliness, fragility and uselessness. Finally, today, we have freed ourselves from the role of "sedentary elderly" and motor activity in the third age is increasingly widespread and relevant as can be seen from the data analysis. This research is the result of a program that has been in place for several years now to combat the hypokinesis diseases, through physical movement and particularly by examples of appropriate lifestyles. This initiative was conceived and implemented by C.I.S.C.O.D. (Comitato Italiano Sport Contro Droga) and CO.NA.P.E.F.S. (Collegio Nazionale Professori Educazione Fisica e Laureati in Scienze Motorie), two C.O.N.I. well-deserving associations, and carried out as part of a larger "Survey on nutrition and culture over 65" project, proclaimed by Sport & Salute S.p.A.
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Exercício Físico , Humanos , Idoso , Inquéritos e QuestionáriosRESUMO
Scientific and technological advances in the diagnosis of neoplastic disease and the introduction of increasingly accurate and personalized anti-cancer treatments have significantly improved the chances of survival of most cancer patients, particularly at a young age. Since the interest of the research community in the life prospects of young cancer survivors has been growing, a new branch of medicine has emerged in recent years that reconciles the potentially gonadotoxic treatments of cancer with the preservation of fertility: oncofertility. The possibility of preserving one's fertility can be of great benefit for the psychological well-being of cancer patients, whose mental health is already severely tested by the cancer diagnosis. Although national and international guidelines urge doctors to start early a discussion on fertility conservation issues (reproductive counseling), still little is known as to the awareness of oncofertility by young cancer survivors and the information they receive about it.
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Sobreviventes de Câncer , Aconselhamento , Preservação da Fertilidade , Fertilidade , Humanos , Neoplasias/terapiaRESUMO
BACKGROUND: Adequate training in tobacco, nicotine dependence and treatment is lacking in Medical School education. With the rise in popularity of electronic alternatives to cigarettes, future physicians should also be provided with the more recent scientific evidence on these products during their undergraduate studies. We introduced an e-learning course for Medical School students and assessed its effec-tiveness of increasing knowledge on these topics. METHODS: We developed 16 didactic modules divided in 3 courses: tobacco dependence (TDI), treating tobacco dependence (TDII) and electronic products and tobacco control (TDIII). The course was offered to 4th, 5th, and 6th year Medical School students in Italy. To assess learning outcomes, we examined the pre- to post- changes in knowledge scores associated with each course. Paired and independent samples t-tests were performed overall, and among smokers and non-smokers separately. RESULTS: A total of 1318 students completed at least one of the courses; 21% were self-reported smokers. A significant increase in knowledge was observed at the end of TDI (pre-course: 52.1±15.9, post-course: 79.9±13.5, p<0.001), TDII (pre-course: 52.5±13.0, post-course: 66.5±12.0, p<0.001) and TDIII (pre-course: 52.2±15.3, post-course: 76.1±17.7, p<0.001). Smokers showed significantly lower improvements compared to non-smokers. CONCLUSIONS: The e-learning course was effective in increasing knowledge about tobacco dependence, treatments, and electronic ni-cotine products in advanced medical students. Given the fundamental role for healthcare practitioners in encouraging and assisting people in quitting smoking, e-learning may be a useful tool in providing up-to-date and standardized training in the area during Medical School.
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Instrução por Computador , Sistemas Eletrônicos de Liberação de Nicotina , Estudantes de Medicina , Tabagismo , Temperatura Alta , Humanos , Faculdades de Medicina , Tabagismo/terapiaRESUMO
OBJECTIVE: The aim of this study was to assess the synergistic effect of non-adherence to the Mediterranean Diet (MD) and lifestyle habits on the occurrence of breast cancer (BC). PATIENTS AND METHODS: A case-control study was carried out from September 2018 to February 2019 at the Teaching Hospital "Umberto I" in Rome. A Food Frequency Questionnaire was used for assessing the level of adherence to MD, the IPAQ Questionnaire to measure physical activity, and AUDIT-C to estimate alcohol consumption. The possible interaction between risk factors was tested using the synergism index. RESULTS: A total of 94 cases and 88 controls were enrolled (median age 55.8 for cases and 57.9 for controls). The MD Score over 6 was associated with low odds of having breast cancer (OR = 0.29; 95% CI: 0.12-0.69). There is a clear indication for the additivity and synergism between non-adherence to MD and many risk factors on the occurrence of BC: current smoker (S = 2.02; 95% CI 0.62-8.07), physical inactivity (S = 2.14; 95% CI 0.71 2-8.28) and alcohol consumption (S = 3.02; 95% CI 0.91-12.95). CONCLUSIONS: Primary prevention of BC can benefit from intervention targeting nutritional and lifestyle factors that act synergistically.
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Neoplasias da Mama/epidemiologia , Dieta Mediterrânea/estatística & dados numéricos , Hábitos , Estilo de Vida , Cooperação do Paciente/estatística & dados numéricos , Idoso , Neoplasias da Mama/prevenção & controle , Estudos de Casos e Controles , Feminino , Humanos , Itália/epidemiologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: In 2015, 37% of Italian adolescents reported to have smoked in the past month. The study aimed to evaluate smoking beha-viour on the school premises and to study the influence of the school environment on student smoking. METHODS: Around 900 junior high-school students, aged 11-13 years old completed an online survey in November 2016 and May 2017. Descriptive statistics, univariate analyses and binary logistic regression were performed to analyse data. RESULTS: Between 40 - 50% of students indicated that students and staff smoke on the school premises. Students who witnessed students (OR: 3.48 (2.20 - 5.50)) and school employees (OR: 3.17 (1.97 - 5.10)) smoking were more likely to be a smoker. CONCLUSION: Although laws making it illegal to smoke on the school ground are in place, in Italy, its enforcement is sloppy. To tackle adolescent smoking effectively, policymakers are advised to enforce smoking restrictions and to verify these are respected.
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Instituições Acadêmicas/legislação & jurisprudência , Instituições Acadêmicas/provisão & distribuição , Política Antifumo/legislação & jurisprudência , Fumar/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Itália , Masculino , EstudantesRESUMO
BACKGROUND: Well-planned mass-media campaigns can increase health literacy and raise awareness about the consequences of tobacco use. This study aims to evaluate the emotions and opinions of adolescents about several anti-tobacco spots delivered by the mass media over the world. STUDY DESIGN: Cross-sectional study. METHODS: The study was conducted in Italy in 2016-2017 among students aged 13-17 years. Students expressed their emotions and opinions about seven anti-tobacco spots from all over the world on different topics and styles. RESULTS: 499 students attended. The video "Sponge" was found to be the most impressive (30.2%) and what they would have chosen if they had been responsible for campaign launched by the Minister of Health (40.5%). The "Icons" spot ranged second, with 19.2% and 17.4%, respectively. CONCLUSIONS: In summary, this study showed that the communication strategies most effective, according to the students interviewed, are those that give clear messages with a scientific profile or that discover the false stereotypes, as in the video "Icons". However, further research is needed to investigate the effectiveness of TV campaigns against smoking, in terms of habits and knowledge in young people.
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Nicotiana , Prevenção do Hábito de Fumar , Adolescente , Publicidade , Comunicação , Estudos Transversais , Humanos , Uso de TabacoRESUMO
PURPOSE: Retinal Vein Occlusion (RVO) is a thrombotic process affecting retinal veins. The purpose of this research is to study demographic characteristics and prevalence of cardiovascular comorbidities among subjects affected by RVO. In addition, authors explore the role of each variable in determining occlusion type and severity. SUBJECTS, MATERIALS AND METHODS: This was a prospective observational study recruiting subjects affected by RVO and secondary macular edema. Exclusion criteria included pre-existing macular edema, recent ocular surgery (<6 months), pregnancy, diagnosis other than RVO, diabetes mellitus type I, any systemic pathology that significantly reduced life expectancy. Each participant was studied through a comprehensive medical history, cardiovascular assessment, blood testing, ocular exam, and macular OCT imaging. RESULTS: A total of 145 eyes, 145 participants, thereof 80 males (55%) and 65 females. (45%) Mean age: 62.5 ± 14.3 SD. 61 eyes (42%) were affected by CRVO and 84 eyes (58%) by BRVO. No statistically significant differences were noted between genders. Hypertension was very prevalent (63%). Dyslipidemia was more associated with BRVO (p = 0.044). Subjects with hypertension had a mean central macular thickness (CMT) of 643 µm against a mean of 489 µm of those without hypertension. (p < 0.05). No other variable was associated with macular edema severity. CONCLUSIONS: Older age and hypertension are strong risk factors for RVO. Dyslipidemia was strongly associated with BRVO. (p=0.044) Hypertension was not only associated with RVO incidence, but also with its severity. In fact, hypertensive subjects had significantly worse macular edema.
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Doenças Cardiovasculares/epidemiologia , Hipertensão/complicações , Oclusão da Veia Retiniana/epidemiologia , Idoso , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Incidência , Edema Macular/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de RiscoRESUMO
BACKGROUND: Healthcare professionals have the potential to influence patients' smoking status; however, their smoking habits and their opinions about tobacco use can hamper an effective counselling about smoking to patients. METHODS: A cross-sectional survey was carried out among healthcare students from the Sapienza University of Rome using a previously validated Italian version of Global Health Professions Student Survey (GHPSS) online questionnaire. RESULTS: Overall, 349 students filled out the online survey: 158 (45%) were current smokers and 191 (55%) were nonsmokers. Nurses students had the highest percentage of smokers (55%). Healthcare students declared they had learned about the health consequences about tobacco use during their academic course (90%), however, only 24% received specific training on smoking cessation. CONCLUSIONS: It is necessary to implement a smoking cessation course in the undergraduate curriculum in order to train healthcare professionals to provide patients an effective counselling against smoking.
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Ocupações em Saúde/educação , Abandono do Hábito de Fumar/psicologia , Fumar/epidemiologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Currículo , Feminino , Humanos , Itália , Masculino , Fumar/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: On March 12, 2020, the World Health Organization (WHO) declared the outbreak of a new Coronavirus disease (COVID-19), to be a pandemic. From the beginning, Italy (in particular the Northern regions) was the first large European country to be hit and one of the most affected countries worldwide. This had a significant impact on the workload and psychological health of health workers. The aim of this web-based cross-sectional study is to assess the consequences of the COVID-19 pandemic on Italian doctors' well-being and psychological distress, in respect of demographic and occupational characteristics, lifestyle and habits during the lockdown period. PATIENTS AND METHODS: We conducted a web-based cross-sectional survey based on Google® Forms to collect data. The participation was available during the lockdown period that started in Italy on March 9, 2020 and it was voluntary and anonymous. The questionnaire explored demographic and occupational variables, lifestyle and habits during the lockdown, perceived well-being and psychological distress. Multivariate logistic regression models were fitted. RESULTS: Our study reported the very alarming psychological conditions of Italian doctors, especially among those who worked in the most affected regions, where a level of psychological distress of 93.8% and poor well-being of 58.9% were registered. These percentages were even higher in the case of female hospital workers with low job seniority, and those caring for COVID-19 patients. CONCLUSIONS: Our findings reported a significant psychosocial impact of the COVID-19 outbreak on Italian doctors, particularly among those working in the most affected regions of the country. Further studies are necessary to better understand the effects of the COVID-19 pandemic on doctors' well-being and mental health over time, in order to implement effective prevention measures.
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Infecções por Coronavirus/patologia , Médicos/psicologia , Pneumonia Viral/patologia , Adulto , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Humanos , Internet , Itália , Solidão , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Angústia Psicológica , Quarentena , SARS-CoV-2 , Fumar , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Recently, the Italian Ministry of Health developed a health prevention campaign against tobacco smoking entitled "Ma che sei scemo? Il fumo fammale" (Are you stupid? Smoking is bad). The aim of this study was to evaluate the diffusion of the ministerial campaign by analyzing data from two web platforms, Facebook and YouTube. METHOD: The study evaluated the dissemination of the campaign using the number of users reached, interactions and the interaction index (interactions/users reached) on the web platform Facebook and YouTube. A qualitative analysis of the text comments left by the users was also carried out. RESULT: The average number of interactions on Facebook was 6,087 and 400 for YouTube while the total views were 356,967 for Facebook and 174,763 for YouTube. The interaction index was very low for both platforms, between 0 and 1%. A total number of 156 comments were obtained on Facebook and 37 on YouTube, most of which were negative, or comments not related to the campaign. CONCLUSIONS: The Italian campaign had low diffusion on the web platforms investigated. Evidence-based public health interventions can play a central role in the prevention field but must be based on elements of scientific effectiveness. Further research should analyze the effects of social media campaigns on direct health related outcomes.
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Promoção da Saúde , Disseminação de Informação , Abandono do Hábito de Fumar , Mídias Sociais , Adolescente , Estudos de Avaliação como Assunto , Feminino , Humanos , Itália , Masculino , Saúde Pública , Pesquisa Qualitativa , Gravação em VídeoAssuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cirurgia Geral/normas , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Operatórios/normas , COVID-19 , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Cirurgia Geral/métodos , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
OBJETCTIVE: The aim of this systematic review was to summarize the scientific literature concerning the use of the Precede-Proceed model (PPM) applied to educational programs and health screenings contextsV. STUDY DESIGN: Systematic review. METHODS: The search process was based on a selection of publications listed in Medline and Scopus. The keywords used were "Precede-Proceed" AND ("screening" OR "educational programs"). Studies included in the systematic review were subdivided into those applying the model in a screening context, and those applying it within educational programs. RESULTS: Twenty-seven studies were retrieved, mostly performed in the USA and, generally, the promoting center was the University. In the context of cancer screening, the PPM model was most of all applied to Mammography Screening (5 of 13 studies in cancer screening), and Cervical Cancer Screening (5 of 13). Another three studies within the cancer field investigated Menopause-Inducing Cancer Treatments, Oral cancer prevention, and cancer screening in general. In the remaining studies, the model was applied in various screening areas, particularly chronic and degenerative diseases. There were many different study designs, most of which cross-sectional (8), though several RTCs (8) and focus groups (5) were also found. For the cross-sectional studies the methodological quality varied between 3/10 and 9/10, whilst for the RCTs it ranged from 2/5 to 3/5. CONCLUSIONS: The PPM provides an excellent framework for health intervention programs especially in screening contexts, and could improve the understanding of the relationship between variables such as knowledge and screening. Given the complexity of a behavioral change process, certain important predisposing factors could be measured in future studies, and during health intervention planning.
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Ciências Biocomportamentais , Programas de Rastreamento , Saúde Pública , Estudos Transversais , Detecção Precoce de Câncer , Humanos , Neoplasias/diagnósticoRESUMO
Introduction: Uveal melanoma is the most common intraocular tumor in the adult population. It can affect any part of the uveal tract: the iris, ciliary body, and choroid. Historically, enucleation has been the mainstay of treatment for primary melanoma. In the last decade, however, radiotherapy has acquired an increasingly important role and has now become our first-line modality. However, it is still widely debated what is the most effective radiotherapy technique for this tumor. Purpose to perform a literature review on the utility of radiotherapy for primary ocular melanoma and determine the most effective radiotherapy technique Materials and Methods: We included all systematic and narrative reviews on the topic, published between September 2007 and November 2017 on PubMed and SCOPUS. Two independent reviewers assessed the eligibility criteria for each article using the PRISMA checklist. The methodological quality of narrative and systematic reviews was evaluated with the INSA and AMSTAR checklists, respectively Results: Our study analyzed a total of 23 studies, including 18 narrative reviews and 5 systematic reviews. Radiotherapy with Brachytherapy, Proton Therapy, SRS/SRT with gamma knife and cyber knife, are the most common choices for the treatment of primary ocular melanoma. These techniques allow for excellent lesion spread control, eye, and vision conservation, and improve overall patients' quality of life. Among the narrative reviews, the highest INSA score was 5/7, the lowest 2/7, the mean was 3.83/7 and median was 4/7. Among the systematic reviews, the highest AMSTAR score was 9/12, the lowest 4/12, the mean 5.6/7 and median 4/7 Conclusion: The number of studies available on this topic is scarce. Among those published, the methodological quality is modest, as assessed with the INSA and AMSTAR checklists. As a result, we are not able to determine what the most effective radiotherapy technique is
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Neoplasias Oculares/radioterapia , Melanoma/radioterapia , Utilização de Procedimentos e Técnicas/estatística & dados numéricos , Radioterapia/métodos , Radioterapia/estatística & dados numéricos , Doenças da Úvea/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: In Italy, health in the workplace is still considered a field for physicians only. In contrast to Europe, the figure of the occupational health nurse is not yet present, due to the absences of contractual and university fields. The present study aimed to carry out a survey for understanding the usefulness of the introduction of the occupational health nurse in the field of prevention and protection of health at work. MATERIAL AND METHODS: The questionnaire was administered via an online survey to health professionals including Students (undergraduate and post-graduate levels) of Nursing Sciences and Midwives, Nurses, Physicians specialized in Hygiene and Preventive Medicine, in Occupational Medicine and Legal Medicine. The questionnaire included 26 questions. The statistical analysis, conducted with SPSS software (release 25.0), has been articulated through the use of frequency tables and contingency tables. Differences in participants' responses were analyzed with the chi-square and Fisher's exact tests, where applicable, considering gender, marital status, presence of sons in families, age, macro-region, and professional activities as potential explanatory variables. RESULTS: After two general reminders, 232 individuals entered the survey, with an overall response rate of 65%. 42.2% of the participants were nurses, aged between 20 and 64 years. Around 70% were females. A low percentage (9.9%) is associated with respondents from northern Italy 53.0% from Center and 37.1% from southern Italy. The questionnaire included four major fields of occupational health nursing. The nursing role for companies (items 8, 12, 13, 14, and 17): the responders approve the introduction of the occupational health nurse in the companies for his/her competences on health promotion and work-related diseases prevention. Utility for companies (items 18, 19, 20 and 21): the usefulness brought by the occupational health nurse to companies is fully shared by the responders. Occupational Health Nurse's action field (items 16, 22, 23 and 24): the answer "yes" has the highest prevalence among the responders, followed by "I don't know". Education (items 25 and 26): Nurses, Physicians and Nursing Students think that the occupational health nurse must have an appropriate university training program, in particular, a master's first degree. Concerning the main focus of the study (opinion on which was the most suitable course of study for the occupational health nurse), 85 (36,6 %) participants answered, "First level Master degree", and 60 (25,9 %) "Advanced training course". CONCLUSIONS: This study wanted to highlight the opinion of professionals on the usefulness of this new nursing figure, projected into the world of occupational medicine. The OHN supports the Physician with his/her professionalism and autonomy in prevention and treatment of work-related diseases, as demonstrated and valued in the rest of Europe. The implementation of advanced courses on occupational nursing, and in particular specific post-graduate degrees, is needed.
Assuntos
Papel do Profissional de Enfermagem , Doenças Profissionais/prevenção & controle , Enfermagem do Trabalho/estatística & dados numéricos , Saúde Ocupacional , Medicina do Trabalho , Adulto , Feminino , Promoção da Saúde , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Enfermeiros/estatística & dados numéricos , Doenças Profissionais/enfermagem , Inquéritos e Questionários/estatística & dados numéricos , Adulto JovemRESUMO
INTRODUCTION: University students are at risk of starting smoking or continuing and increasing the consumption of tobacco products. The aim of the study was to assess the impact of the training course, Sisma Project, about smoking in healthcare degree courses, in terms of knowledge, behaviour and to evaluate the course. METHODS: SISMA project was a pre- post study about an intervention delivered to healthcare profession students about smoking and smoking cessation. It had a before-after design and was an online optional course available on the eLearning platform Moodle 2. The course was structured in four lessons of sixty minutes, a debate among experts and a final test of evaluation. The McNemar test was used to measure the effectiveness of Sisma on smoking behaviour of students after the intervention. Students rated the course assigning a score from one to ten, and expressed free comments about point of strength and weakness of Sisma project. RESULTS: The participants were 365 students, 28.5% males and 71.5% females, most were nursing 194 (53.2%) and dental hygienists students 105 (28.8%). Current smokers were 161 (44.1%) before and 142 (38.9%) after the course, there was statistical significant difference in smoking status after attending the course (p < 0.001). Students evaluated the course giving a high score with a mean of 8.13 (SD: 1.1); the main points of strength were the content (33.2%), the structure (15.6%) and knowledge given by the course (12.6%). The main point of weakness were the online structure 62 (37%), problem related to length and time 17 (10%) and the final test 15 (9%). DISCUSSION: Given the central role health professionals play in patient care, students need to be aware and trained in tobacco cessation techniques. Our results indicate that smoking behaviour significantly changed after attending a university course for smoking cessation and students appreciated its contents and structure.