[The role of nurses in health education about vaccines: analysis of style and communication models of institutional vaccination campaigns]. / Ruolo dell'infermiere nella educazione alla salute in ambito vaccinale: analisi dello stile e dei modelli di comunicazione delle campagne vaccinali istituzionali.

Vaccine hesitancy represents an increasingly important global health issue. Nurses, together with other healthcare professionals, can play a key role in increasing vaccination uptake. The aim of this article is to analyze the main elements of positive communication styles used in vaccination campaigns and initiatives. The most important components in style, construction and contents used in several vaccination campaigns were evaluated through an original instrument, specifically developed for the present study. The most relevant aspects of nursing expertise and competencies were mixed with foundations of mass communication theory, in order to develop a framework made by 13 items, useful to evaluate different aspects of immunization campaigns. A multi-professional project was developed, to obtain a deep integration between nurse expertise in health promotion and other groups with similar public health orientation. The Authors further evaluated sociological instruments and theories from other fields, as mass communication theory and the social/behavioral approach. An integrative review was performed, about the following main themes: vaccination adherence basis; nurse role in health promotion; health education competences; multi-professionals integration in public health; positive communication style; efficacy evaluation. Key elements were collected, to prepare an original instrument to be used in evaluating several communication campaigns. The evaluation framework (13 items) was prepared and applied to vaccine communication in different institutional settings in the last five years. Main components are: elements taken from main communication models (persuasive communication models); nurse competencies in health education; public health expertise (from an expert panel). The main findings of this study regard the usefulness of evaluating main aspects of communication in the vaccine field. Nurses' knowledge and competencies in health promotion and health education add relevant meanings and cues to act against the causes for not vaccinating. It shows that is worth analyzing the main aspects of communication techniques and evaluating innovative methods to increase population confidence levels in public health.

Diabetic Foot Infection: Preliminary Results of a Fast-Track Program with Early Endovascular Revascularization and Local Surgical Treatment.

BACKGROUND: To demonstrate that a fast-track program consisting in early endovascular revascularization and local surgical treatment saves tissue in patients with diabetic foot infection (DFI). METHODS: Between January and December 2014, 48 patients with DFI underwent early endovascular revascularization and local surgical treatment at our Diabetic Foot Center. In all cases, endovascular revascularization and local surgical treatment were performed within 1 week from the diagnosis of infection and during the same hospital stay. One-year outcomes were evaluated in terms of survival, primary patency, primary-assisted patency, secondary patency, absence of target lesion restenosis (TLR), and limb salvage. RESULTS: The patients were predominantly males (34 of 48, 70.8%) with a mean age of 72.4 years (range, 51-91). The target vessel was a tibial artery in 34 cases (70.8%). Surgical treatment consisted of debridement without bone resection in 27 cases (56.2%), toe and/or ray amputation in 15 cases (31.2%), Lisfranc amputation in 2 cases (4.2%), transmetatarsal amputation in 2 cases (4.2%). In the remaining 2 cases, a leg amputation was necessary with an overall 30-day major amputation rate of 4.2%. During the follow-up (mean duration 6.9 months, range 1-12) healing of the lesions was obtained in 30 cases (62.5%). Estimated 12-month survival, primary patency, primary-assisted patency, secondary patency, absence of TLR, and limb salvage rates were 83.5%, 53.4%, 65%, 65%, 60.7%, and 86.6%, respectively. CONCLUSIONS: A fast-track program consisting in early endovascular revascularization and local surgical treatment contributes to our experience in limiting amputation levels in patients with DFI. A multidisciplinary approach and adoption of diabetic foot triage are essential to achieve these outcomes.