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Fatigue is still present in up to 40–50% of kidney transplant recipients (KTR), the results of studies comparing the prevalence among patients on hemodialysis (HD) and KTR led to conflicting results. Fatigue correlates include inflammation, symptoms of depression, sleep disorders and obesity. Fatigue in KTR leads to significant functional impairment, it is common among KTR poorly adherent to immunosuppressive therapy and is associated with a serious deterioration of quality of life. The following databases were searched for relevant studies up to November 2020: Medline, PubMed, Web of Science and the Cochrane Library. Several studies have compared the prevalence and severity of fatigue between KTR and hemodialysis or healthy patients. They have shown that fatigue determines a significant functional deterioration with less chance of having a paid job and a significant change in quality of life. The aim of the review is to report methods to assess fatigue and its prevalence in KTR patients, compared to HD subjects and define the effects of fatigue on health status and daily life. There is no evidence of studies on the treatment of this symptom in KTR. Efforts to identify and treat fatigue should be a priority to improve the quality of life of KTR. [ABSTRACT FROM AUTHOR]

Aim: Nurses use their smartphones during the work shift. The objective of this review is to investigate the presence of bacteria on mobile phones and the procedures to disinfect or decontaminate the smartphone and decrease the infection rate., Method: This systematic review was carried out through a search on the main scientific databases by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research was conducted by considering articles published in the last ten years., Results: Of 502 initial articles, 489 were excluded and 12 articles were considered relevant. Twelve articles were included in the review. The analysis of the studies showed a high contamination of pathogenic microorganisms on the device's surfaces, most of which appear to be antibiotic resistant. The use of smartphones during clinical practice increases the risk of contracting nosocomial infections. The presence of bacteria on mobile phones and their use favors the cross-transmission of microorganisms., Conclusion: Onset prevention is a primary goal for the entire multidisciplinary team. There are no protocols concerning smartphones disinfection during clinical practice, but their implementation would reduce the incidence by improving nursing care.

Background and Aim of the Work: In the advanced stages of Parkinson's Disease, patients need complex care and support, especially at home, where they often receive assistance by familial caregivers. However, caregivers may be or feel unable to cope with their role and, despite the needs of caregivers are often assessed in the literature, their opinions and feelings about these needs are not widely explored yet. This study aimed at exploring the opinions and feelings about their educational needs and role of familial caregivers of Parkinson's Disease patients., Methods: A qualitative study was conducted from October to December 2017 in a polyclinic of central Italy. Fourteen caregivers voluntarily participated in the study; semi-structured face-to-face interviews were conducted, and audio recorded until data saturation. Two investigators reviewed the transcribed notes, created Meaning Units, Sub-categories and finally the Categories with emerged themes., Results: The analysis of the 14 interviews generated three categories: supportiveness of healthcare educational programs; sense of inability to manage caregiver tasks; need for interaction with other familial caregivers., Conclusions: The caregivers declared their belief that healthcare educational courses can be useful in helping them live and understand the caregiving tasks and expressed their need to share their experiences with other caregivers. In fact, they often they felt abandoned and poorly trained for the patient's management at the home. The clinical practice should allow healthcare professionals to meet the training and emotional needs of caregivers and create a trust relationship with them to make caregivers skilled in caring for patients.

The remote monitoring of patients is based on digital systems that enable the remote collection, usually at home, of health data and its transmission to health centers. The telemedicine paradigm is of particular interest in chronic diseases, fragile population and elderly monitoring. Parkinson's disease (PD) is a neurodegenerative disorder having high impact on the lives of patients and their families. Such a disease impacts on the physical and psychological abilities of the patient and may have an effect on the relationship among family members. The strict monitoring of PD patients and their caregivers is of paramount importance in the implementation of prompt actions counteracting the worsening of the disease or that of the caring process. In this paper we present a mobile App developed for PD patients and their caregiver. The App aims at improving the communication among the patient/caregiver and the specialists, covering aspects related to both the disease symptoms and the caring process. In the paper we describe the App along with results collected during a one year experimentation on a cohort of 10 patients and 7 caregivers. The results show that the approach is accepted by patients and caregivers. Furthermore, obtained results demonstrate that the monitoring system is effective in the identification of dangerous conditions for the patient and useful in the implementation of reactive health management strategies.