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Salvatore Sardo,1,2 Maura Galletta,2 Erica Coni,3 Cesar Ivan Aviles Gonzalez,1 Ilenia Piras,4 Giorgio Pia,4 Maurizio Evangelista,5 Mario Musu,1,2 Gabriele Finco1,2 1Anesthesia and Intensive Care Unit, University of Cagliari, Cagliari, Italy; 2Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; 3RN-BC, University of Cagliari, Cagliari, Italy; 4ATS Sardegna, ASSL Cagliari SS, Cagliari, Italy; 5Department of Anesthesiology and Pain Medicine, Cattolica University, Rome, ItalyCorrespondence: Maura GallettaDepartment of Medical Sciences and Public Health, University of Cagliari, Highway 554 (exit for Sestu), Monserrato 09042, Cagliari, ItalyTel +39 070-675-3108Email maura.galletta@gmail.comPurpose: The aim of this prospective study was to assess the behavior of emergency department (ED) nurses with regard to pain and their role in pain management in a real-life clinical setting.Methods: A total of 509 consecutive patients were enrolled during a 6-week period. A case-report form was used to collect data on nurses’ approaches to pain, time to analgesia provision, and patient-perceived quality of analgesia.Results: Triage nurses actively inquired about pain in almost every case, but they did not estimate pain intensity in a third of patients. In the majority of cases, triage nurses did not report pain-related findings to the physician, who was the only professional that could prescribe analgesia to patients. The assignment of the color-coding of triage by nurses appears to be related to the perceived severity of the clinical case and a more comprehensive evaluation of pain. More than half of patients were at least fairly satisfied with analgesia.Conclusion: Pain is increasingly screened during triage, but its comprehensive assessment and management still lack systematic application. We believe that further education and implementation of analgesia protocols may empower nurses to manage ED patients’ pain more effectively and in a more timely manner.Keywords: emergency, ED, nurse, oligoanalgesia, pain, triage

Introduction: Dementia, depression, and cardiovascular disease are major public health concerns for older adults, requiring early intervention. This study investigates whether a virtual reality cognitive remediation program (VR-CR) can improve cognitive function and depressive symptoms in older adults, and determines the necessary sample size for future studies. Integrated VR and CR interventions have shown promising outcomes in older adults with neurodegenerative and mental health disorders., Methods: This secondary analysis of a randomized controlled trial involves adults aged 58-75 years with bipolar disorder, excluding those with acute episodes, epilepsy, or severe eye diseases. The experimental group received standard treatment plus VR-CR, while the control group received only standard treatment., Results: No baseline differences were found between the experimental and control groups. No significant improvement was observed in the overall cognitive function test ( p = 0.897) or in depressive symptoms ( p = 0.322). A phase III efficacy study requires a sample size of 28 participants (alpha = 0.05, beta = 0.20)., Conclusions: VR-CR can potentially treat depressive symptoms in adults and older adults, but the results support conducting phase III studies to further investigate these outcomes. However, the improvement in cognitive performance in the elderly is less pronounced than in younger individuals.

To verify if lethality and diffusivity of Covid-19 correlated with percentage of people vaccinated in different countries and whether results on these indicators were comparable under different types of vaccines. A linear regression analysis was conducted between vaccines/inhabitant, new cases/inhabitants and ratio deaths/cases. A comparison between the three indicators was carried out in countries subdivided by kind of vaccine. The proportion of vaccinations/inhabitants correlates negatively with proportion of deaths × 100 cases ( R  = -3.90, p  < 0.0001), but didn't on incidence of new cases. Countries with prevalence of mRNA vaccines were similar to others on incidence of new cases; but a lower lethality of Sars-Cov2 was found than in countries with prevalence of viral vehicle vaccines ( F  = 6.064, p  = 0.0174) but didn't against countries with prevalence of inactivated vaccines. The higher is the proportion of vaccine/inhabitant in a given country, the less is the fraction of infected people who die., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)