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. Impact of 12-hour shifts on nurse, patient and organizational outcomes. A critical review., Introduction: The use of 12-hour shifts has been considered beneficial in reducing staffing costs, attracting more nurses, improving work-life balance, and organizing care more efficiently., Objective: The aim of this review is to critically examine the available evidence on the impact of 12-hour shifts on nurse, patient, and organizational outcomes., Methods: A critical review of the literature was undertaken. Quantitative, qualitative and mixed methods studies analyzing the effect of long shifts (>12 working hours) were included. The search was performed on MEDLINE through PubMed and Cinhal., Results: Fifty-four articles were included, covering publications from 1976 to 2024. Evidence suggests that nursing care and patient safety may deteriorate with 12-hour shifts, with mixed findings on continuity of care. 12-hour shifts can lead to increased nurses' fatigue, without a decrease in job performance, and can have negative impacts on physical health, continuing education, burnout, and job satisfaction. While qualitative studies indicate improved work-life balance, this is not supported by empirical evidence. One study suggests a decrease in costs, but the effects on sick leave are inconclusive. Additionally, intention-to-leave among nurses appears to increase., Conclusions: The evidence generally does not support the use of 12-hour shifts. However, due to methodological limitations in the included studies, firm conclusions cannot be drawn. Organizations and nurses should carefully consider the introduction of 12-hour shifts, evaluating nurses' needs and implementing patient-centered care models that support nursing professionalism, along with a continuous monitoring of patient, nurse, and organizational outcomes.

This is the second contribution of a series of updates on some of the oncological emergencies. The updates are published in the form of a case, with multiple-choice questions to assess knowledge, a brief discussion of the answer, and reference literature, to further explore the topic presented. This case involves the management of malignant bowel obstruction from an ovarian cancer.

. A fever in a neutropenic patient during chemotherapy: case report with questions. Over the next 3 issues, we will publish a series of updates on some of the oncological emergencies. The updates are published in the form of a case, with multiple-choice questions to assess knowledge, a brief discussion of the answer, and the reference literature, to further explore the topic. The first case involves the management of febrile neutropenia.

Unlabelled: . Italian validation of the Chemotherapy Induced Taste Alteration Scale. Introdution. Taste alterations (TAs) are an underestimated side effect despite affecting 75% of chemo-radiotherapy patients. TAs may cause discomfort and food aversions up to loss of appetite and anorexia. The available instruments do not discriminate the different types of TAs., Aim: The aim of the study is to validate the Italian version of CiTAS, a 18-items scale that assesses specific TAs, symptoms of discomfort and their impact on patient nutrition., Methods: A convenience sample of 243 patients with chemotherapy-induced taste alterations were enrolled. Data were analyzed for item consistency using Cronbach alpha and construct validity using factor analysis., Results: The factor analysis identified four dimensions that explained a total variance of 67%: decline in basic taste, discomfort, phantogeusia and parageusia, and general taste alterations. The scale showed good validity (Cronbach's alpha = 0.82)., Conclusions: The CiTAS enabled the valid and reliable measurement of specific symptoms of chemotherapy-induced TAs. It can be used both as a clinical tool and in future studies to evaluate the effectiveness of specific TAs treatments.

Taste disorders in cancer patients. Introduction. Taste disorders are a relevant but often underestimated and under reported symptom in cancer patients. Taste disorders can be a consequence of the illness or its treatment, especially in head and neck cancer patients. Aims. To describe the physiologic mechanisms of taste disorders in cancer patients, their assessment and possible strategies for prevention and treatment. Methods. Literature review. Results. Taste disorders affect quality of life and may be responsible of the occurrence of food aversions with possible weight loss and malnutrition, associated to worst outcomes for toxicity and survival. In spite of the progresses in the last decade, the assessment of taste disorders is far from being satisfactory. In fact research focused on gastrointestinal consequences of illness and treatments, reserving only a marginal attention to taste disorders, in spite of their prevalence. The available knowledge of the mechanisms underlying the development of taste disorders in cancer patients are presented, together with assessment and treatment and prevention strategies. Discussion. Taste disorders are underreported and underestimated, in spite of their prevalence, especially in cancer patients, possibly for the wrong assumption that they cannot be treated. This may explain why they are often not reported by patients.