Patient's needs in substitutive dialysis treatment. Some psycho-social and organizational considerations.

BACKGROUND: The observations here presented come from an action-research project carried out at the Dialysis Centre of Ivrea. The work is focused on the articulation between subjective (the felt experience) and objective variables (the structure and intervention typology) with the aim of understanding patient's needs from an organizational point of view. METHODS: A questionnaire to evaluate the needs of dialytic patients and the burden that these have on the health service and staff, was formulated by the nurses. RESULTS: The results showed how the patient's clinical history indicate, significantly, not only personal and subjective aspects (e.g. interpersonal relationships), but also how they construct their relationships with the hospital and its services (including the hospital staff). CONCLUSIONS: Data open up certain reflections on what role communication and information play within the hospital structure. Efficient communication contributes both to reduce the anxiety level and to improve the organizational climate therefore influencing service quality.

Absorption and excretion of cobalt in the hard metal industry.

Absorption and excretion of cobalt in the hard metal industry was investigated by means of ambient air and urine measurements in three factories with high levels of environmental cobalt pollution. In the presence of poor hygiene conditions and permission to smoking during work, there was no relationship between cobalt ambient air and cobalt urine concentrations. Such a finding was therefore attributed to a substantial skin contact. A simple experiment of skin exposure to freshly mixed or waste powder on volunteers identified a ten-fold increase of cobalt in urine in the post-exposure samples, thus confirming the contribution of dermal exposure as a route of entry. An improvement in the hygiene of the working conditions helped to investigate the relationship between exposure and excretion level. Cobalt uptake through the different routes of entry may be substantial, and requires a more prolonged exposure-free period so that the excretion rate can be reduced to the reference population level.

[Multiple myeloma and occupational risk factors: a case-control study]. / Mieloma multiplo e fattori di rischio occupazionali: studio caso controllo.

In order to identify possible relationships between multiple myeloma (MM) and occupational factors, a hospital-based case control type study was carried out on 94 cases of MM and on 188 controls matched for sex, age (S.D. = 2 years) and area of residence, suffering from orthopaedic trauma and free of chronic/degenerative or tumoral diseases. All jobs done for at least a year in a period of 5-30 years before diagnosis were considered. Statistical analysis showed a significant correlation between MM and agricultural work (OR 1.82; I.C. 95% 1.03-3.25), which agrees with the data in the literature. The etiopathogenetic hypotheses reported in the literature are discussed and proposals for further research are made.