Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
Más filtros










Base de datos
Intervalo de año de publicación
2.
Front Psychol ; 14: 1030043, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36818073

RESUMEN

Workplace ostracism is an essential predictor of knowledge-sharing behaviors, but few studies have explored the influence of this mechanism in higher education. According to the conservation of resources theory, this study elucidated the roles of job burnout and job satisfaction as sequential mediators of the link between workplace ostracism and knowledge-sharing behaviors in a sample of 388 university teachers. The results of the study were analyzed via structural equation modeling (SEM). Higher knowledge-sharing behaviors were associated with lower workplace ostracism, lower job burnout, and more job satisfaction. Furthermore, increased workplace ostracism was associated with more job burnout, but job satisfaction was not related to workplace ostracism. The relationship between workplace ostracism and knowledge-sharing behaviors was mediated by job burnout and was sequentially mediated by job burnout and job satisfaction. These findings help to clarify the mechanisms underlying the association between workplace ostracism and knowledge-sharing behaviors in university teachers. The theoretical and practical implications of the findings are discussed.

3.
Front Pediatr ; 10: 894589, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35664881

RESUMEN

Background: Delirium is an acute brain dysfunction associated with increased length of hospitalization, mortality, and high healthcare costs especially in patients admitted to the pediatric intensive care unit (PICU). The Cornell Assessment of Pediatric Delirium (CAPD) is a screening tool for evaluating delirium in pediatric patients. This tool has already been used and validated in other languages but not in Italian. Objectives: To test the reliability of the Italian version of the CAPD to screen PICU patients for delirium and to assess the agreement between CAPD score and PICU physician clinical evaluation of delirium. Methods: Prospective double-blinded observational cohort study of patients admitted to a tertiary academic center PICU for at least 48 h from January 2020 to August 2021. We evaluated intra- and inter-rater agreement using the Intraclass Correlation Coefficient (ICC). The ability of the scale to detect delirium was evaluated by comparing the nurses' CAPD assessments with the clinical evaluation of a PICU physician with expertise in analgosedation using the area under the ROC curve (AUC). Measurements and Main Results: Seventy patients were included in the study. The prevalence of pediatric delirium was 54% (38/70) when reported by a positive CAPD score and 21% (15/70) when diagnosed by the PICU physician. The CAPD showed high agreement levels both for the intra-rater (ICC 1 0.98, 95% CI: 0.97-0.99) and the inter-rater (ICC 2 0.93, 95% CI: 0.89-0.96) assessments. In patients with suspected delirium according to the CAPD scale, the observed sensitivity and specificity of the scale were 0.93 (95% CI: 0.68-1.00) and 0.56 (95% CI: 0.42-0.70), respectively. The AUC observed was 0.75 (95% CI: 0.66-0.8490). Conclusion: The Italian version of the CAPD seems a reliable tool for the identification of patients at high risk of developing delirium in pediatric critical care settings. Compared to the clinical evaluation of the PICU physician, the use of the CAPD scale avoids a possible underestimation of delirium in the pediatric population.

4.
Pharmacotherapy ; 42(2): 145-153, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34882826

RESUMEN

STUDY OBJECTIVE: Withdrawal syndrome (WS) may be a critical drawback of opioid/benzodiazepine weaning in children. The most effective intervention to reduce WS prevalence is yet to be determined. Dexmedetomidine (DEX) was estimated to be effective in reducing WS-related symptoms, but no randomized trial has been conducted to prove its efficacy so far. We aimed to evaluate the efficacy and safety of DEX in reducing the occurrence of WS. DESIGN AND SETTING: This was an adaptive randomized double-blind placebo-controlled trial conducted at three Italian Pediatric Intensive Care Units (PICUs). PATIENTS: It included children admitted to PICU, undergoing at least five days of opioids/benzodiazepines continuous infusion, and ready to start the analgosedation weaning. INTERVENTION: Twenty-four hours before the start of weaning, an infusion of DEX/placebo was started. WS symptoms were monitored using the Withdrawal-Assessment-Tool-version-1 (WAT-1). In case of WS symptoms (WAT-1 ≥ 3) an opioid/benzodiazepine bolus was given and the DEX/placebo infusion-rate was increased. MEASUREMENTS: The primary outcome measure was the prevalence of WS. Secondary outcomes were the trend of WAT-1 over time, number of rescue doses, length of weaning and PICU-stay, and onset of adverse events (AEs). MAIN RESULTS: Forty-five patients were enrolled, of whom 5 dropped-out and 40 entered the interim analysis. There were no significant baseline differences between groups. WS prevalence did not significantly differ between groups (77.8% DEX vs 90.9% placebo, p = 0.381). By generalized linear mixed modeling, the WAT-1 trend showed a significant increase per unit of time in the DEX arm (estimate 0.27, CI 0.07-0.47, p = 0.009) compared to placebo. Most frequent AEs were hemodynamic, and all of them happened in the DEX arm. CONCLUSIONS: A continuous infusion of DEX, started 24 h before the analgosedation weaning and increased based on WS signs, was not able to significantly modify the prevalence of WS in children who received at least five days of opioids/benzodiazepines treatment compared to placebo.


Asunto(s)
Dexmedetomidina , Síndrome de Abstinencia a Sustancias , Analgésicos Opioides , Benzodiazepinas/uso terapéutico , Niño , Dexmedetomidina/efectos adversos , Humanos , Hipnóticos y Sedantes/efectos adversos , Unidades de Cuidado Intensivo Pediátrico , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Síndrome de Abstinencia a Sustancias/epidemiología , Síndrome de Abstinencia a Sustancias/prevención & control
6.
Paediatr Anaesth ; 25(12): 1227-34, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26432066

RESUMEN

BACKGROUND: Errors in are estimated to occur with an incidence of 3.7-16.6% in hospitalized patients. The application of systems for detection of adverse events is becoming a widespread reality in healthcare. Incident reporting (IR) and failure mode and effective analysis (FMEA) are strategies widely used to detect errors, but no studies have combined them in the setting of a pediatric intensive care unit (PICU). AIM: The aim of our study was to describe the trend of IR in a PICU and evaluate the effect of FMEA application on the number and severity of the errors detected. METHODS: With this prospective observational study, we evaluated the frequency IR documented in standard IR forms completed from January 2009 to December 2012 in the PICU of Woman's and Child's Health Department of Padova. On the basis of their severity, errors were classified as: without outcome (55%), with minor outcome (16%), with moderate outcome (10%), and with major outcome (3%); 16% of reported incidents were 'near misses'. We compared the data before and after the introduction of FMEA. RESULTS: Sixty-nine errors were registered, 59 (86%) concerning drug therapy (83% during prescription). Compared to 2009-2010, in 2011-2012, we noted an increase of reported errors (43 vs 26) with a reduction of their severity (21% vs 8% 'near misses' and 65% vs 38% errors with no outcome). CONCLUSION: With the introduction of FMEA, we obtained an increased awareness in error reporting. Application of these systems will improve the quality of healthcare services.


Asunto(s)
Cuidados Críticos/métodos , Enfermedad Crítica/terapia , Unidades de Cuidado Intensivo Pediátrico/organización & administración , Errores Médicos/prevención & control , Insuficiencia del Tratamiento , Adolescente , Niño , Preescolar , Documentación , Quimioterapia/normas , Control de Formularios y Registros , Humanos , Lactante , Recién Nacido , Unidades de Cuidado Intensivo Pediátrico/normas , Estudios Prospectivos , Mejoramiento de la Calidad , Gestión de Riesgos , Análisis y Desempeño de Tareas , Resultado del Tratamiento
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...