Effectiveness of Expressive Writing protocol in Palliative Care Healthworkers: a quantitative study.

BACKGROUND AND AIM OF THE WORK: Palliative Care professionals are exposed to intense emotional environment. This puts them at risk for Compassion Fatigue and Burnout. The protective factors that can counter their onset are Compassion Satisfaction, Organizational Commitment and Resilience. Expressive Writing is a valid tool for adapting to traumatic events and enhancing psychological well-being. Aim of this study is to evaluate the effect of the Expressive Writing in Palliative Care professionals on Compassion Satisfaction, Organizational Commitment, Resilience, Compassion Fatigue and perceived distress. METHODS: Prospective experimental study with experimental/control groups and pre/post measurements. 50 Palliative Care professionals were recruited in Northern and Central Italy. Participants filled: Organizational Commitment Questionnaire; ProQol - revision III; Resilience Scale for Adults; Impact of Event-Scale Revised; Emotion Thermometer; ad hoc questionnaire for the evaluation of protocol usefulness. RESULTS: Wilcoxon test demonstrated change in Continuative Commitment (Z = -3.357, p = .001), anger (Z = -2.214, p = .027), sleep (Z = -2.268, p = .023), help (Z = -2.184, p = .029), intrusiveness (Z = -2.469, p = .014), hyperarousal (Z = -2.717, p = .007), and total IES (Z = -2.456 , p =, 014). Mann Whitney test showed a significantly lower score on post-test Intrusiveness in the experimental group (U = 202, p = .038). CONCLUSIONS: The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.

Scalp Cooling in Daily Clinical Practice for Breast Cancer Patients Undergoing Curative Chemotherapy: A Multicenter Interventional Study.

OBJECTIVE: Chemotherapy-induced alopecia is a common and distressful side effect, especially among breast cancer patients. Scalp cooling (SC) can reduce hair loss during anthracycline- and taxane-based chemotherapy. This study assessed the effectiveness of SC in daily clinical practice in three Italian oncology units. METHODS: From 2014 to 2016, we prospectively included 220 female early-stage breast cancer patients undergoing curative chemotherapy in combination with SC using the Paxman device. Effectiveness was defined as the severity of hair loss according to the Common Terminology Criteria for Adverse Events Version 4.0 as follows: Grade 0, no hair loss; Grade 1, <50% hair loss not requiring a wig; and Grade 2, ≥50% hair loss at each cycle and at completion of chemotherapy. The tolerability and safety were also evaluated. RESULTS: The overall success rate of SC (hair loss Grade 0-1) was 68%. Severe hair loss was avoided in 89% of women receiving taxane-based chemotherapy and in 78% of women receiving both anthracyclines and taxanes. Among women undergoing anthracycline-based chemotherapy, 47% experienced hair preservation. SC was well tolerated, as only 20 patients discontinued SC for reasons other than hair loss. CONCLUSIONS: Our study confirmed that SC provides a reliable chance for breast cancer patients to keep their hair during taxane- and/or anthracycline-based chemotherapy.

Qualification of high-recovery, flocked swabs as compared to traditional rayon swabs for microbiological environmental monitoring of surfaces.

In microbiological environmental monitoring programs, swabs are widely used for hygiene monitoring of surfaces and operators. Traditional rayon swabs are generally used and considered the gold standard in swab collection. Two experimental studies were conducted to validate the performance of a new collection device for environmental monitoring of surfaces, called flocked swabs, manufactured by microRheologics (Brescia, Italy). The first experimental study consisted of comparing flocked swabs' recovery and release capacity to traditional rayon swabs from known microorganism inocula (spiked samples); the second experimental study compared the recovery capacity from samples obtained in routine environmental surfaces sampling of pharmaceutical areas, microRheologics flocked swabs compared to traditional rayon swabs showed an improvement in the percentage of recovery of contamination from surfaces from 20% up to 60%, and the findings were confirmed from a preliminary evaluation of routine environmental surface sampling of pharmaceutical areas. microRheologics flocked swabs also displayed an instant and nearly complete release of absorbed samples of more than 80%.

Continuous microbiological air monitoring for aseptic filling lines.

BACKGROUND: Pharmaceutical aseptic filling lines are used to fill sterile biotechnology products without affecting their quality by a terminal sterilization step. Standard grade A filling environments are required to have < 1 colony-forming unit (CFU) per cubic meter (m3) of air. Aseptic filling is the production cycle with one of the highest contamination risks. A typical method of contamination monitoring is to actively draw air and filter it through special gelatin filters. OBJECTIVE: The study aims to establish whether continuous sampling provides effective monitoring for the entire production process by determining whether trapped organisms can withstand long-term drying stress with unaltered recovery. METHODS: In two experimental phases, the study examined microbial recovery in long-term air-stressed membranes as well as the viability of microorganisms on gelatin filters during 8-hour runs of filtration with high-efficiency particulate air-filtered air from a laminar flow hood using the MD 8 Airscan system. Stressed and unstressed filters were compared with parallel-run reference filters as controls. The CFUs were counted and the genus of the identified microorganism populations determined to examine any changes in microbiological flora occurring during continuous long-term sampling. RESULTS: Compared to the unstressed reference filters, neither total recovery nor recovered bacterial diversity changed. No statistically significant differences in CFUs were found between test filters and reference filters, nor were any statistically significant differences found in the microbiological flora between test filters and reference filters. CFU populations were comparable in both experiments. CONCLUSION: Eight hours of continuous air sampling on gelatin filters with the MD 8 Airscan system did not affect total recovery or change the diversity of recovered microorganisms compared to the controls.