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To evaluate the diagnostic performance of third trimester ultrasound for the diagnosis of clinically significant Placenta accreta spectrum disorder (PAS) in women with a low-lying placenta (less than 20 mm from the internal cervical os) or placenta praevia (covering the os) METHODS: Pregnant women with a low-lying placenta or placenta praevia, age ≥ 18 years and gestational age at ultrasound ≥ 26+0/7 weeks of gestation were prospectively included in the study. Ultrasound suspicion of PAS was raised in the presence of at least one of these signs: (1) obliteration of the hypoechoic space between the uterus and the placenta; (2) interruption of the hyperechoic interface between the uterine serosa and the bladder wall; (3) abnormal placental lacunae. In order to assess the ability of ultrasound to detect clinically significant PAS, a composite outcome comprehensive of both active management at delivery and histopathological confirmation of PAS was considered as the reference standard. PAS was considered of clinical significance if, in addition to histological confirmation, at least one of these procedures was carried out after delivery: use of hemostatic intrauterine balloon, compressive uterine suture, peripartum hysterectomy, uterine/hypogastric artery ligation, uterine artery embolization.

Background and aim of the work: Influenza is a disease that affects a large part of the world's population annually, with major health, social and economic impacts. Active immunisation practices have always been recommended to counter influenza, especially for people at risk. The recommendations of major health agencies strongly advise influenza vaccination for all healthcare workers, mostly for those in contact with at-risk or immunocompromised individuals. Yet, the influenza vaccination coverage among healthcare workers remains rather low worldwide. This review explore barriers and the facilitators of health care professional toward influenza's vaccination. Methods: Narrative review consulting the databases: PubMed, CINAHL by combining keywords health care worker, flu, influenza, vaccination, barrier, resistence, hesitangy, between November 2019 and February 2020 Results. From the 1031 records initially, twenty-two primary studies were included in this narrative review. Our results show that the identified facilitators are: desire for self-protection, protection for loved ones and community. Instead, the barriers to vaccination identified are: fear of contracting influenza from the vaccination itself; not considering themselves at risk; to believing believe that their immune system is capable of managing a trivial disease; disease considered trivial, laziness; false beliefs. Discussion and conclusion: Adherence rate on influenza vaccination among health professionals is quite low. The interventions that make it "complex and traceable" flu vaccination refusal increase adherence to this type of vaccination. The results show that current vaccination campaigns do not increase the rate of adherence by healthcare workers. Identifying the predisposing factors and barriers to such vaccination can help to create, develop and test targeted educational programmes.

Introduction: The progressive ageing and ever-increasing life expectancy of the world’s population are accompanied by an increase in chronic debilitating pathologies. Italy continues to be the nation with the highest percentage of senior citizens. Over the past decades, the recourse to hospitalisation is destined only to acute care while it is entrusted to the territory of the care of chronicity. Recent economic crises and movements of social change have led to a gradual increase in the use of homecare workers for the territorial and family management of chronic illnesses. Contrary to happened in the other countries, in Italy prevailed an informal logic regarding the recruitment and use of these workers, hindering the evolution of this sector. Aim: This study focuses on the role of homecare workers in Italian research. Results: From the analysis of heterogeneous Italian literature, the importance of homecare workers is clear. Their work not only influences assisted individuals but also informal caregivers and the direct costs of Italian national health system. Conclusion: Homecare workers in Italy’s society are important. The little attention the scientific literature has paid to this population may be due to the difficulty of finding subjects with a legal status and, therefore, willing to participate in specific investigations. Investigating the dyad of care and extending these investigations to the family surrounding context seem to be the main priorities that should be explored in future research.

Introduction: Nurses are at greater risk of violence during their working hours. About 31% of all aggressions towards nurses occur in hospital or in care settings. The problem of aggressions on healthcare workers is difficult to classify, as the number of aggressions is often underestimated. For this reason, the aim of this study is to analyze physical, verbal and sexual aggressions on nursing staff and identify their predictors. Methods: A cross sectional study was performed. A sample of convenience was recruited consisting of nurses practicing in the Italian territory. The research team recruited subjects from various hospital, outpatient or territorial settings. The criteria for participation in the study were: (1) being registered nurses; (2) not being in an idle state (e.g. retirement). Multiple linear regression was used to identify the predictive variables of physical, verbal and sexual aggression. Results: The sample consisting of 518 nurses had an average age of 37.5 years.The sample consisted prevalently of female subjects, with medium-high educational attendance. About 90% of the sample claims to have suffered physical, verbal and / or sexual aggressions during their working hours. People with a lower educational level, belonging to the southern regions are more at risk of physical and verbal aggression, while the female gender is a predictor of sexual assaults. Conclusions: The results of this study highlight how physical, verbal and sexual violence in nursing staff are non-isolated but highly frequent issues, being part of the daily working life of many health professionals.

Objectives: To investigate knowledge, attitudes, and behavior of nurses working in acute care hospitals regarding clinical risk and patient safety, and to identify predisposing factors. Design: Cross-sectional multicenter study. Methods: The study was conducted in thirteen non-teaching acute public and private hospitals of a region of southern Italy from September through December 2015. A structured self-report questionnaire was administered to clinical nurses working in the hospitals involved. Three multivariate linear and logistic regression models have been constructed: knowledge of the definition of an adverse event; attitude towards risk of making an error while working; and nurses who reported at least one error in the past 12 months. Results: The sample consisted of 484 respondents out of 670 (72.2%) nurses approached. The final multivariable model showed that educational courses about patient safety play a significant role in nurses gaining knowledge of adverse events. In the absence of organization-wide patient safety programs, nurses with low knowledge levels showed a significantly higher perceived risk. Nurses (n=96) who made errors over the past 12 months had discussed them with head nurses (75%) and colleagues (41.7%). Anonymous reporting to the organization was very low, with only 8.3% of nurses who had made an error submitting an anonymous report. Conclusions: Managers should implement multimodal improvement strategies aimed at enabling nurses’ to recognize the critical issues of the system and to increase their reporting, in order to make the organizations safer.

OBJECTIVES: To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction. METHODS: This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC)

Background: Cancer is the leading cause of death worldwide. Of the various therapeutic approaches, chemotherapy is the most widely used treatment. Among the various side effects associated with this treatment, taste alterations (TAs) have received little attention, even though they have a serious impact on the nutritional aspect and quality of life (QoL) of patients. TAs concern 75% of the patients receiving chemotherapy, and this figure is still considered to be underestimatedbeacuse could be due both to inadequate attention and to the absence of specific subjective tools able to fully evaluate TAs in patients undergoing chemotherapy. Methods: A review by querying CINAHL, PubMed, Scopus and Google Scholar databases about the current status of use of the CiTAS self-evaluation scale, was performed. Results: From critical reading of the selected reports, it can be said that until now CiTAS has not been used to a large extent for evaluating taste, even at a late stage in patients undergoing chemotherapy. However, the results and the selected reports seem to indicate hope for its wider use. Conclusions: In literature, CITAS scale has been used on very heterogeneous populations and not adequately studied in specific care settings, its use within controlled trials could implement its spread. Correct and subjective evaluation of TAs would allow the planning of specific and personalized interventions aimed at providing adequate nutrition to support the maintenance and/or achievement of a correct body mass index. All this could contribute significantly to a better perception of QoL in patients undergoing chemotherapy. (www.actabiomedica.it)

Introduction: The quality of life of subjects who survived to acute myocardial infarction (AMI) is evaluated through the perception of their sexual life too. Contrary to recommendation write in international guidelines, this aspect is often overlooked, in fact patients who had suffered a AMI and their healthcare professionals do not appear to give proper attention to this aspect. After a heart attack resume to a normal sexual activity reduces anxiety, stress, depression and can improve quality of life. The doubts and fears that arise in patients after a myocardial infarction prevent proper recovery of sexual activity; often, these fears are unfounded and quickly disappear, but their presence puts the patient and partner’s relationship and also their quality of life at risk. Aim: The aim of the study was to understand the experience of the sexual health of Italian women one year after acute myocardial infarction. Methods: Phenomenology by Cohen. Results: ‘‘Fear of recurrence of infarction’’, ‘‘stress’’ and ‘‘the need to receive spontaneous information’’ are the main themes emerged from our analysis of interviews. Conclusions: Sexuality for myocardial infarction’s survivors is an important aspect of one’s health and quality of life. Understanding the lived experience about it in the health of women must stimulate careful consideration in all health workers and encourage rehabilitation programs that do not neglect this aspect.