Aims – This study aims to explore: a) the feasibility of psycho-educational interventions for families of users with schizophrenia in clinical practice by trained staff; b) the benefits and problems ...encountered by professionals in the use of these interventions. Methods – 46 professionals from 23 Italian Mental Health Sen'ices (MHS) attended at a three-module training course in psycho-educational interventions and four supervisions in the subsequent year. Following the course, participants provided the intervention to families of users with schizophrenia. The difficulties and benefits encountered by trainees to use the intervention were registered on the Family Intervention Schedule.Results – 83% of the participants completed the training course. Following the course, the intervention started in 71 families from 17 MHS. 76% of trainees provided the intervention to 2-5 families, while 13% of them only held informative sessions on schizophrenia. During the supervision period, the organisational difficulties experienced by the professionals were stable, while the benefits increased. Differences in benefits and difficulties were detected in relation to the trainees’ experience and professional roles. Conclusions – It is possible to introduce psycho-educational interventions in MHS after a relatively brief period of training and supervision of the staff. Organisational difficulties need to be addressed to increase the dissemination of these interventions on a large scale. Declaration of Interest: None of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by grants received from the “M. Lugli” Foundation (grant n. 2/18/8) and from the National Institute of Health, Italy (grant no. 1AL/F3).
This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' clinical status and disability and relatives' burden and perceived support.
The study ...has been carried out in 17 mental health centres. In each of them, 2 professionals were trained in a psychoeducational intervention and applied it for six months with families of users with schizophrenia. At baseline and six months later, patients' clinical status and disability, and relatives' burden, social network and professional support were assessed by validated tools.
Of the seventy-one recruited families, 48 (68%) completed the intervention. At six months, a significant improvement was found in patients' clinical status and social functioning, as well as in relatives' burden and social and professional support. In particular, the percentage of patients with poor or very poor global social functioning dropped from 50% to 27% at six months. Forty percent of patients and 45% of relatives reported a significant improvement in their social contacts over the intervention period.
The results of this study confirm the hypothesis that psychoeducational family interventions may have a significant effect on social outcome and family burden in schizophrenia when provided in routine conditions.
Objectives
To investigate the correlation between quantitative flow ratio (QFR), Pd/Pa, diastolic hyperemia‐free ratio (DFR) and fractional flow reserve (FFR, gold standard) in non‐culprit lesion ...(NCL) of patients with non ST‐segment elevation myocardial infarction (NSTEMI).
Background
The non‐hyperemic pressure ratio (NHPR) and the angiography‐based indexes have been developed to overcome the limitation of the use of the FFR.
Methods
Between January and December 2019, 184 NCL from 116 NSTEMI patients underwent physiologic assessment and were included in the study. NCLs were investigated with QFR, Pd/Pa, DFR, and FFR. Mean values of QFR, Pd/Pa, DFR and FFR were 0.85 ± 0.10, 0.92 ± 0.07, 0.93 ± 0.05 and 0.84 ± 0.07, respectively.
Results
DFR and FFR showed a good correlation (r = 0.76). Bland and Altman plot showed a mean difference of 0.080. DFR Diagnostic accuracy was 88%. The area under the ROC curve (AUC) for DFR was 0.946 (95%CI 0.90–0.97, p = .0001). Similar findings were reported for Pd/Pa (r = 0.73; mean difference 0.095, diagnostic accuracy 84%, AUC 0.909 95%CI 0.85–0.94, p = .0001) and QFR (r = 0.68; mean difference 0.01; diagnostic accuracy 88%, AUC 0.964 95% CI 0.91–0.98, p = .0001). FFR, QFR, Pd/Pa and DFR identified 31%, 32%, 30% and 32% potentially flow‐limiting lesions, respectively.
Conclusions
In NSTEMI patients, QFR, Pd/Pa and DFR showed equivalence as compared to gold standard FFR in the discrimination of non‐culprit lesions requiring revascularization.
Introduction:
Chemical, Biological, Radiological, and Nuclear (CBRN) emergencies need specific hospital preparedness and resource availability.
Preparing to evaluate and manage victims from CBRN ...exposure events in one aspect of hospital preparedness, is often underestimated. Specific skills and capabilities are required to manage these events. Emergency department (ED) and hospital staff need adequate training to provide safe and effective care.
Method:
The Hospital Complex of Valtellina and Alto Lario (with three hospitals), in consideration of the geographic location amid mountains, far from urban hospital centers, decided to develop an intensive training program for the hospital emergency staff. Firstly, it was based on an eight-hour initial training program, using a combined civilian military approach that included hazard recognition, substance identification, site safety, response roles, PPE use, and decontamination procedures. The CBRN Operational Unit (for prevention of chemical-biological-radiological-nuclear risks) of the 1st Territorial Unit of the Auxiliary Military Corps of the Order of Malta Italy led such training session showing that a military approach to CBRN threats can be used with civilian and military competencies and tools in managing specific hazardous events hospital first responders may face.
Results:
A drill exercise was performed on a radiological fall-out incident to test the hospital’s emergency response staff preparedness. Hospital management and decontamination
procedures were analyzed to treat victims as well as first responders and to train hospital staff with few resources available.
Conclusion:
Hospitals need a specific level of preparedness to enable an effective response to CBRN emergencies. Skills and competencies of military personnel can be a resource in these kinds of events to train civilian personnel who are not normally acquainted to or confident to manage this kind of CBRN events, and can represent a new model and challenge of interagency cooperation in the disaster management of complex emergencies involving hazardous materials.
