How to improve the identification of patients with cancer eligible for genetic counselling?

OBJECTIVE: International guidelines recommend genetic counselling and if indicated the genetic testing for treatment, disease prevention and follow-up for patients and their relatives. However, there is limited utilisation of genetic counselling. This study aimed to verify whether an individual semi-structured guideline-based interview improves the identification of patients eligible for genetic counselling. METHODS: Unselected patients with cancer were interviewed. A dedicated nurse provided an ad-hoc guideline-based questionnaire to assess the presence of criteria for a possible hereditary breast and ovarian cancer syndrome or hereditary non-polyposis colorectal cancer syndrome (Lynch syndrome). The interest of patients to undergo genetic counselling was also investigated. RESULTS: Ninety patients were enrolled in the study; 20 (22.2%) of these had already undergone genetic counselling. The interview identified 23 (32.8%) of the remaining 70 patients that were eligible for genetic counselling. Two-third of the patients (n = 59) were interested in genetic counselling irrespective of socio-demographic factors or cancer type. A logistic regression analysis for age, gender, parental status, educational level and cancer type did not reveal any independent factor that was associated with patients who had previous genetic counselling. CONCLUSIONS: Our preliminary findings suggest that a semi-structured guideline-based interview can substantially improve the identification of patients eligible for genetic counselling.

COVID-19 in Workplaces: Secondary Transmission.

OBJECTIVES: Coronavirus disease (COVID-19) contagion at work is well studied for healthcare workers, however it is not enough assessed in other working settings. Very little is known, indeed, about the risk of COVID-19 transmission through occupational exposure in non-health working places. This study aims to describe a COVID-19 cluster among workers in an office in Italy. METHODS: This was a retrospective observational study on a cluster of COVID-19 that occurred from 20 November through 3 December 2020 in a group of six colleagues (A-F) working in the same office full time 5 days a week, 8 h a day. The workers used the following prevention measures: social distancing (desks were >1 m, 1.76-5.01 m range), plexiglas panels, hands disinfection, and use of face mask. However, they did not wear face mask when in static position sitting at their desk and they did not aerate the place frequently. RESULTS: The disease spread from one worker (subject A) to four (80%) of the five colleagues (subjects B-F). Only subject D was negative to COVID-19 on 14 days after last contact with subject A (20 November 2020) as confirmed by nasopharyngeal swab testing. Subject D, in particular, did not contact subject A in the 48 h before symptoms onset. COVID-19 positivity of subject A was promptly communicated to the colleagues, who started self-isolation from their relatives and none of their households were infected. COVID-19 transmission was observed only in households of subject A. CONCLUSIONS: The rapid communication of COVID-19 positivity to the colleagues and the prompt isolation of index case's close contacts allowed to eliminate the secondary transmission to their households. The contagion of index case's colleagues occurred from second day before symptoms onset. Distancing of >1 m, use of plexiglass panels, sanitizing hand gel, and inconstant use of face mask may not be enough for infection prevention in closed places with poor ventilation and high occupancy.

[Nursing education for the management of cardiocirculatory emergency in a hospital environment]. / La formazione infermieristica per la gestione dell'emergenza cardiocircolatoria intraospedaliera.

The aim of the study is to evaluate how nurses are trained to deal with in-hospital emergencies . Cardiocirculatory arrest represents the epitome of extreme emergency since lack of perfusion to vital organs can cause death in a few minutes and immediate life-saving measures are necessary. Hence, all health workers , and nurses in particular , must be specifically trained. The study was performed in a central Italian hospital to assess the level of knowledge regarding these techniques, the relative equipment and their practical application.

[Risk Management and analysis of an adverse event: accidental patients falls]. / Il risk management attraverso l'analisi di un singolo evento avverso: la caduta accidentale del paziente.

The matter of safety of operators and users within health care is becoming more and more topical. The relationship between users and operators with the health structures is a very relevant and expensive circumstance. For this reason some years ago a new culture for clinic risk was born, called risk management (RM), its goal is to create prevention, which focuses on patients and on the risks they take at the moment in which they keep in contact with health structures. We have take into consideration the matter of accidental falls of hospitalized patients occurred in year 2003 at the Hospital of S. Croce of Fano (PU) and made a careful check of the report file prepared by the Health Management of the body mentioned. The unfavorable event we considered is resulted to be of modest entity (0,56% of falls on the total amount of patients hospitalized) uniformly distributed all year long. The most involved patients were male, almost all hospitalized in General Medicine and Geriatrics ward. Most of all individuals fallen down did not produce particular effects. The falls happened commonly during night. Patients who fell down are completely or partially self-supporting. Through a study of all data we collected we defined two variants which interact: on one side the quality of medical assistance, the nurse assistance in particular, and the characteristics of patients fallen down on the other side. Literature too confirm our statements and underline the need to identify the danger points to define the subjects in risk of fall. We found relevant under the present health background to focus our attention on health risks, in particular the accidental fall in hospitals, which has to be considered an important event carry out the monitoring the quality of health assistance.