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Background: Caring for patients with COVID-19 requires wearing a full set of personal protective equipment (PPE) to avoid contamination. Personal discomfort has been associated with use of PPE, and anecdotal reports describe pressure injuries related to wearing PPE. Objectives: To investigate the occurrence of device-related pressure injuries due to wearing PPE among Italian nurses caring for patients with COVID-19 in critical care settings. Methods: This descriptive study used an online survey investigating both the demographic characteristics of respondents and complications related to wearing PPE, including the development of pressure injuries. Results: A total of 266 nurses throughout Italy completed the survey; 32% of respondents were men. Nurses' median age was 36 years (range 22-59 years), and the median time spent working in their current clinical setting (an intensive care or high-dependency unit) was 3 years (range 0-32 years). Personal protective equipment was worn for a median duration of 5 hours (range 2-12 hours). While wearing PPE, 92.8% of nurses experienced pain and 77.1% developed device-related pressure injuries, mainly on the nose and forehead. Pain was more frequent among nurses with such injuries. Transparent dressings, emollient cream, and no dressing were associated with development of device-related pressure injury. Conclusions: Pressure injuries related to PPE represent an important adverse effect for nurses caring for patients with COVID-19. This topic deserves study to determine adequate solutions for preventing and treating such injuries and their potential influence on nurses' work tolerance.

This paper provides a first manual analysis of the use of 14 gender-specific swear words in Swiss WhatsApp messages in (Swiss) German, French and Italian. We will show that gender-specific swear words only concern non-participants of the discourse when used offensively, in our data. When such items are directly addressed to the interlocutor, they are rather used ironically or even hypocoristically. Furthermore, we will show that gendered hate speech in this context is not a matter of mutual discrimination by the two sexes, but that Swiss WhatsApp users also refer to people of their own sex using gender-specific swear words.

In this paper, we will present a study on the comprehension of figurative language (metaphor and irony) in children with hearing aids (HA). We focused on this specific population in order to gain a better understanding of the factors that could modulate the understanding of metaphors and irony.

The promotion of agroforestry as a mitigation practice requires an understanding of the economic benefits and its acceptability to farmers. This work examines the agroecological and socio-economic factors that condition profitability and acceptance of agroforestry by smallholder farmers in Western Kenya. We differentiate the use of trees according to the permanence of carbon sequestration, introducing a distinction between practices with “high mitigation benefits” (timber) and practices with “low mitigation benefits” (fuelwood). This study goes beyond the analysis of incentives to plant trees to identify incentives to plant trees that lead to high mitigation outcomes. We show that environmental factors shaping the production system largely drive the choice for planting trees with high mitigation benefits. Most trees in the area are used for fuelwood, and the charcoal economy outweighs economic factors influencing planting of trees with high mitigation benefits. Larger households tend to produce more fuelwood, while high mitigation uses are positively related to the education level of the household head, and to the belief that trees play a positive role for the environment. Where trees contribute significantly to incomes, the norm is that they are owned by men. We conclude that although agroforestry is not perceived to be more profitable than traditional agricultural practices, it plays an important economic and environmental role by supporting subsistence through provision of fuelwood and could relieve pressure upon common forest resources. In areas with high tree cover, it also represents a way of storing capital to deal with risks and cope with uncertainty.

Objective: Families of ICU patients have a pressing need for information: they find themselves suddenly in a complex technical environment often because of a life-threatening illness of a loved one. Some evidence suggests that specific communication tools (like websites or brochures) could improve the experience of ICU families. Design: Randomized, multicenter, stepped wedge trial for large-scale assessment of the effectiveness of a multitasking intervention to improve communication with families of critically ill patients. Main outcome: correct understanding of the prognosis. Secondary outcomes: correct understanding of medical treatments, prevalence of anxiety, depression and post-traumatic stress symptoms in the first ICU week. Prevalence of PTSD 6 months from ICU discharge. Empathy and burnout among ICU staff. Prevalence of refusals for tissues/organ donation, and medical claims. Subjects: 2100 ICU relatives of critically ill patients. Interventions: The intervention employs specific tools especially designed to raise the correctness of information and to improve the quality of communication: a website presenting the ICU world and justifying the relatives' emotions, with a webpage specifically dedicated to each participating ICU; a standard brochure; eight posters for the families' waiting room and a signboard for the ICU door. Measurements and main results: The study plans to assess these materials in up to 300 Italian ICUs that will participate, according to a five waves program, each one with randomized starting order. This way the effect of the intervention will be evaluated simultaneously. Conclusion: This is an educational study, aiming to spread good medical practices, while also verifying their real effectiveness in a large number of ICUs. Trial registration number: NCT03438175.

This book provides essential insights into how the approach to nursing care in ICU patients has markedly changed over recent years. It shows how the focus has progressively moved away from the technical approach that characterized early ICUs to a wider personalization of patient care that also highlights general problems such as basic hygiene and general comfort. It also demonstrates that, at the same time, the nurses' role has become more professionalized, with increasing competences in assessing and managing patients' problems and measuring related outcomes. It is structured in four units: Unit 1 presents the essential elements of accurate vital-function and basic-needs assessments for ICU patients, using both instrumental monitoring and specially validated assessment tools. Unit 2 addresses basic care in ICU patients, particularly hygiene and mobilization, reflecting recent developments in nursing that focus on the importance of these activities. Unit 3 highlights the main nursing outcomes in ICU patients, particularly focusing on risk prevention and complication management. Lastly, Unit 4 discusses advances in ICU nursing, from clinical, organizational and research perspectives

The basic care involves all those activities performed in each context of care and in intensive care units that characterize the nurses’ job, drawing attention to sensitive outcomes such as infection prevention and patients’ safety.In this chapter, we will discuss how the basic nursing care to the person in the intensive care unit (ICU) is widely different if compared to other departments, and, especially, the eye, mouth, and skin care management and the bed bath will be highlighted. In particular, oral hygiene care, using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of Ventilator-associated pneumonia (VAP) in critically ill patients. Using chlorhexidine gluconate (CHG) for body hygiene allows to reduce the transmission of infections, but it is still debated if it contributes completely to the reduction in infections in ICU. Hygiene care in critical care patients may significantly alter vital signs, therefore a strict haemodinamic and respiratory monitoring.