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Tartaglia A, Corson T, White KB, Charlescraft A, Jackson-Jordan E, Johnson T, Fitchett G. Chaplain staffing and scope of service: benchmarking spiritual care departments. J Health Care Chaplain 2024; 30:1-18. [PMID: 36102782 DOI: 10.1080/08854726.2022.2121579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The functions of hospital chaplains and the corresponding staffing of spiritual care departments remain persistent and parallel questions within the profession. No consensus exists on services provided by spiritual care departments nor the staffing patterns to meet those expectations. This study describes the key activities and staffing at the 20 U.S. News and World Report Best Hospitals 2020-2021 as well as the connections between services, staffing, and select hospital characteristics such as average daily census. Information about each hospital's chaplaincy department was gathered via a Zoom/telephone assisted survey with its spiritual care manager. Findings reveal that while spiritual care departments are structurally integrated into their organizations and chaplains respond consistently to requests for care, involvement in established organizational protocols varies. Study findings support the notion that staffing levels are a function of chaplain integration into an organization and the activities organizations expect chaplains to fulfill.
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Affiliation(s)
- Alexander Tartaglia
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Tyler Corson
- College of Health Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Kelsey B White
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Ann Charlescraft
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Tricia Johnson
- College of Health Sciences, Rush University Medical Center, Chicago, IL, USA
| | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
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Tartaglia A, White KB, Corson T, Charlescraft A, Johnson T, Jackson-Jordan E, Fitchett G. Supporting staff: The role of health care chaplains. J Health Care Chaplain 2024; 30:60-73. [PMID: 36520544 DOI: 10.1080/08854726.2022.2154107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim of this study was to describe the range of spiritual care activities in support of clinical colleagues at a subset of U.S. hospitals. A descriptive cross-sectional design using a 76-item Zoom/telephone guided survey containing a subset of staff care questions was employed. Data were provided by directors/managers responsible for spiritual care services at the 2020-2021 U.S. News & World Report top hospitals. Results identified staff support as an important chaplaincy function at both organizational and spiritual care department levels. Staff chaplains at over half of the hospitals spend an estimated 10-30% of their time on staff care, with chaplains in five hospitals spending greater than 30%. The most frequently reported activities were religiously associated, such as blessings and rituals for hospital events. Additionally, chaplains actively support staff during critical events such as patient deaths and through organizational protocols such as code lavender and critical incident debriefings. Chaplain support for staff most commonly grew out of personal relationships or referrals from clinical managers. Future research opportunities in this area include systematic data collection for chaplains' specific staff support activities as well as efforts to investigate the impact of those activities on patient experience.
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Affiliation(s)
- Alexander Tartaglia
- Patient Counseling, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelsey B White
- Patient Counseling, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Tyler Corson
- Adjunct Faculty, College of Health Sciences, Rush University, Chicago, IL, USA
| | - Ann Charlescraft
- Retired Faculty, Patient Counseling, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Tricia Johnson
- Professor, Health Systems Management, College of Health Sciences, Rush University Chicago, IL, USA
| | | | - George Fitchett
- Professor, Religion, Health and Human Values, College of Health Sciences, Rush University, Chicago, IL, USA
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Matos MA, Almeida ND, Hocevar LS, Tartaglia A, Salles C, DE Souza AJ. One stage procedure for developmental dysplasia of the hip in patients aged eight years or older. Systematic review and meta-analysis. Acta Orthop Belg 2023; 89:45-50. [PMID: 37294984 DOI: 10.52628/89.1.8940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of the present study is to perform a systematic review with meta-analysis of the literature on treatment of developmental dysplasia of the hip (DDH) in patients over eight years of age to provide better understanding of therapeutic strategies and results. Authors carried out a systematic review and metanalysis of the literature on DDH treated in patients aged eight years of age or older. A literature search was carefully performed from June 2019 to June 2020. The articles had to report one stage reconstructive surgical treatment of DDH for patients eight years or older, presenting clinical and radiographic evaluation according to the Tonnis and Severin, and McKay systems. Meta-analysis was carried out using the software metanalyst to perform the pooled effect size Nine studies met the inclusion criteria. They assessed a total of 234 patients and 266 hips. Female patients accounted for 75.7% (eight unknown) and the follow-up ranged from 1 to 17.4 years. The majority of the procedures included an acetabular surgery (93.9%) while femoral shortening was performed in 78%. Acceptable outcomes were found in between 67% (Mckay system) and 91% (Severin system) of the cases. Femoral varus and derrotation shortening associated with redirectional osteotomy of the acetabulum (for those with closed triradiate cartilage) or acetabular redirection/reshaping were the most prevalent combined procedures; this strategy can lead to 60% of acceptable clinical results and 90% of radiographically acceptable results. Therefore, our findings give credence to the recommendation for the treatment of DDH in patients over eight years old.
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Locatelli M, Covone S, Rosato E, Bonelli M, Savini F, Furton K, Gazioglu I, D'Ovidio C, Kabir A, Tartaglia A. Analysis of seven selected antidepressant drugs in post–mortem samples using fabric phase sorptive extraction followed by high performance liquid chromatography-photodiode array detection. Forensic Chem 2022. [DOI: 10.1016/j.forc.2022.100460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Szilagyi C, Tartaglia A, Palmer PK, Fleenor DW, Jackson-Jordan E, Knoll Sweeney S, Slaven JE. Delivering Clinical Pastoral Education (CPE) Remotely: Educators’ Views and Perspectives During the COVID-19 Pandemic and Beyond. J Pastoral Care Counsel 2022; 76:189-209. [PMID: 35499920 PMCID: PMC9066239 DOI: 10.1177/15423050221094492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many Clinical Pastoral Education programs pivoted to remote delivery during the
COVID-19 pandemic. Our survey explored educators’ preparedness, self-efficacy,
and views regarding remote Clinical Pastoral Education. Few respondents were
either very (14.2%) or not at all (16.5%) prepared. Most were confident
facilitating remote learning (69.8%–88.5%), believing remote Clinical Pastoral
Education can achieve outcomes equivalent to in-person (59.1%). Six qualitative
themes emerged: educator development, educator challenges, remote Clinical
Pastoral Education efficacy, remote group dynamics, clinical
practice/supervision implications, and benefits and opportunities.
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Affiliation(s)
| | | | | | | | | | | | - James E. Slaven
- Indiana University School of Medicine, Indianapolis, IN, USA
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Szilagyi C, Tartaglia A, Palmer PK, Fleenor DW, Jackson-Jordan E, Knoll Sweeney S, Slaven JE. COVID-19 and Clinical Pastoral Education: How ACPE Educators Pivoted Amid the Pandemic. J Pastoral Care Counsel 2022; 76:37-47. [PMID: 35060791 PMCID: PMC8926918 DOI: 10.1177/15423050211073572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Clinical Pastoral Education (CPE) programs faced extraordinary challenges during the COVID-19 pandemic. We examined how ACPE-certified educators responded to maintain program delivery. Survey results (n = 210) suggested a substantial and abrupt increase in remote delivery for CPE instruction and supervised clinical practice, primarily driven by those previously fully in-person. Respondents reported abrupt changes impacted 1152 students. Participants rated their utilization and helpfulness of professional, organizational, and technology resources during the pivot and beyond.
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Affiliation(s)
| | | | | | - David W. Fleenor
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - James E. Slaven
- Indiana University School of Medicine, Indianapolis, IN, USA
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Merone G, Tartaglia A, Rossi S, Santavenere F, Bassotti E, D'Ovidio C, Rosato E, de Grazia U, Locatelli M, Boccio PD, Savini F. Fast LC–MS/MS screening method for the evaluation of drugs, illicit drugs, and other compounds in biological matrices. Talanta Open 2022. [DOI: 10.1016/j.talo.2022.100105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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8
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Tartaglia A, Romasco T, D'Ovidio C, Rosato E, Ulusoy HI, Furton KG, Kabir A, Locatelli M. Determination of phenolic compounds in human saliva after oral administration of red wine by high performance liquid chromatography. J Pharm Biomed Anal 2021; 209:114486. [PMID: 34847459 DOI: 10.1016/j.jpba.2021.114486] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 01/18/2023]
Abstract
Red wine is a relevant source of bioactive compounds, which contribute to its antioxidant activity and other beneficial advantages for human health. However, the bioavailability of phenols in humans is not well understood, and the inter-individual variability in the production of phenolic compounds has not been comprehensively assessed to date. The present work describes a new method for the extraction and analysis of phenolic compounds including gallic acid (Gal), vanillic acid (Van), caffeic acid (Caf), syringic acid (Sir); (-)-epicatechin (Epi); p-coumaric acid (Cum) and resveratrol (Rsv) in human saliva samples. The target analytes were extracted using Fabric Phase Sorptive Extraction (FPSE), and subsequently analysed by high-performance liquid chromatography (HPLC) coupled with photodiode array detector (PDA). Chromatographic separation was achieved using a Symmetry C18 RP column in gradient elution mode, with methanol and phosphate buffer as the mobile phases. The linearity (intercept, slope, and determination coefficient) was evaluated in the range from 1 to 50 µg/mL. The limit of quantification (LOQ) was 1 µg/mL (LLOQ ≥0.8 µg/mL), whereas limit of detection was 0.25 µg/mL. The intra and inter-day RSD% and BIAS% values were less than± 15%. The analytical performances were further tested on human saliva collected from healthy volunteers after administering red wine. To the best of our knowledge, this is the first FPSE procedure for the analysis of phenols in saliva, using a non-invasive and easy to perform sample collection protocol. The proposed fast and inexpensive approach can be deployed as a reliable tool to study other biological matrices to proliferate understanding of these compounds distribution in human body.
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Affiliation(s)
- A Tartaglia
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy
| | - T Romasco
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy
| | - C D'Ovidio
- Department of Medicine and Aging Sciences, Section of Legal Medicine, University of Chieti-Pescara "G. d'Annunzio", Chieti 66100, Italy
| | - E Rosato
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy
| | - H I Ulusoy
- Department of Analytical Chemistry, Faculty of Pharmacy, Cumhuriyet University, Sivas 58140, Turkey
| | - K G Furton
- International Forensic Research Institute, Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
| | - A Kabir
- International Forensic Research Institute, Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
| | - M Locatelli
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy.
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Merone GM, Tartaglia A, Rossi S, Santavenere F, Bassotti E, D'Ovidio C, Bonelli M, Rosato E, de Grazia U, Zanardo A, Locatelli M, Savini F. Fast liquid chromatography-tandem mass spectrometry method for the simultaneous determination of phytocannabinoids in oily based preparations. J Pharm Biomed Anal 2021; 203:114174. [PMID: 34062478 DOI: 10.1016/j.jpba.2021.114174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 01/08/2023]
Abstract
The reported method aims to be a powerful aid for the simultaneous determination of tetrahydrocannabinol (THC), cannabidiol (CBD), cannabinol (CBN), cannabigerol (CBG), tetrahydrocannabinolic acid (THCA), cannabidiolic acid (CBDA), and tetrahydrocannabivarin (THCV) in oily based preparations. The chromatographic separation was carried out using an Hypersil Gold PFP (50 × 2.1 mm, 1.9 μm) column, using H2O + 2 mM ammonium formate + 0.2 % formic acid (M1) and Methanol + 2 mM ammonium formate + 0.2 % formic acid (M2) as mobile phases. The flow rate was set 0.4 mL/min. Specifically, this method was validated in terms of linearity, limit of detections and quantifications (LODs and LOQs), accuracy (precision and trueness, both intra and interday), selectivity, and matrix effects. This procedure allowed quantifying seven phytocannabinoids in less than 10 min. The validated method shows a good linearity within the range 0.25-1000 ng/mL, while precision and trueness (intra- and inter-day) were below <13.25 % and 7.59 %, respectively. Regarding the matrix effect, the method satisfies all the requirements, except for the THC and THCV, where it reaches about 120 %. This element does not affect the method performances as it has been observed that this value is constant and reproducible and therefore does not involve errors in the quantitative analysis. The method was tested and applied on more 70 different oily based preparations. Furthermore, starting from four different cannabis cultivar (FM2, Bedrolite, Bedrocan, and Bediol), it allowed to evaluate the reproducibility of the magistrali preparations. The real samples, in fact, derive from different local pharmacies, and were analyzed by the accredited UNI CEI EN ISO/IEC 17025:2018, Pharmatoxicology Laboratory (ACCREDIA, lab n. 2274 ASLPE, accreditation number 1822 L), accordingly to the current regulations.
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Affiliation(s)
- G M Merone
- Pharmatoxicology Laboratory - Hospital "Santo Spirito", Via Fonte Romana 8, Pescara, 65124, Italy
| | - A Tartaglia
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti, 66100, Italy
| | - S Rossi
- Pharmatoxicology Laboratory - Hospital "Santo Spirito", Via Fonte Romana 8, Pescara, 65124, Italy
| | - F Santavenere
- Pharmatoxicology Laboratory - Hospital "Santo Spirito", Via Fonte Romana 8, Pescara, 65124, Italy
| | - E Bassotti
- R&D Department Eureka Lab Division, Chiaravalle, Italy
| | - C D'Ovidio
- Department of Medicine and Aging Sciences, Section of Legal Medicine, University of Chieti-Pescara "G. d'Annunzio", Chieti, 66100, Italy
| | - M Bonelli
- Department of Medicine and Aging Sciences, Section of Legal Medicine, University of Chieti-Pescara "G. d'Annunzio", Chieti, 66100, Italy
| | - E Rosato
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti, 66100, Italy
| | - U de Grazia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Laboratory of Neurological Biochemistry and Neuropharmacology, Via Celoria 11, 20133, Milan, Italy
| | - A Zanardo
- Section of Pharmatoxicology - Regional Hospital "Ca' Foncello", Piazzale Ospedale 1, Treviso, 31100, Italy
| | - M Locatelli
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti, 66100, Italy.
| | - F Savini
- Pharmatoxicology Laboratory - Hospital "Santo Spirito", Via Fonte Romana 8, Pescara, 65124, Italy
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Heisey-Grove DM, McClelland LE, Rathert C, Tartaglia A, Jackson K, DeShazo JP. Associations Between Patient Health Outcomes and Secure Message Content Exchanged Between Patients and Clinicians: Retrospective Cohort Study. J Med Internet Res 2020; 22:e19477. [PMID: 33118938 PMCID: PMC7661231 DOI: 10.2196/19477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023] Open
Abstract
Background The number of electronic messages securely exchanged between clinic staff and patients has risen dramatically over the last decade. A variety of studies explored whether the volume of messages sent by patients was associated with outcomes. None of these studies, however, examined whether message content itself was associated with outcomes. Because secure messaging is a significant form of communication between patients and clinic staff, it is critical to evaluate the context of the communication to best understand its impact on patient health outcomes. Objective To examine associations between patients’ and clinicians’ message content and changes in patients’ health outcomes. Methods We applied a taxonomy developed specifically for secure messages to 14,394 patient- and clinic staff–generated messages derived from patient-initiated message threads. Our study population included 1602 patients, 50.94% (n=816) of whom initiated message threads. We conducted linear regression analyses to determine whether message codes were associated with changes in glycemic (A1C) levels in patients with diabetes and changes in systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Results Patients who initiated threads had larger declines in A1Cs (P=.01) compared to patients who did not initiate threads. Clinic nonresponse was associated with decreased SBP (β=–.30; 95% CI –0.56 to –0.04), as were staffs’ action responses (β=–30; 95% CI –0.58 to –0.02). Increased DBP, SBP, and A1C levels were associated with patient-generated appreciation and praise messages and staff encouragement with effect sizes ranging from 0.51 (A1C) to 5.80 (SBP). We found improvements in SBP associated with patients’ complaints (β=–4.03; 95% CI –7.94 to –0.12). Deferred information sharing by clinic staff was associated with increased SBP (β=1.29; 95% CI 0.4 to 2.19). Conclusions This is the first research to find associations between message content and patients’ health outcomes. Our findings indicate mixed associations between patient message content and patient outcomes. Further research is needed to understand the implications of this work; in the meantime, health care providers should be aware that their message content may influence patient health outcomes.
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Affiliation(s)
- Dawn M Heisey-Grove
- MITRE Corporation, McLean, VA, United States.,College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Laura E McClelland
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Cheryl Rathert
- Department of Health Management and Policy, Saint Louis University, St Louis, MO, United States
| | - Alexander Tartaglia
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Kevin Jackson
- Department of Nursing and Allied Health, College of Science, Engineering, and Technology, Norfolk State University, Norfolk, VA, United States
| | - Jonathan P DeShazo
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
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Tartaglia A, Kabir A, D'Ambrosio F, Ramundo P, Ulusoy S, Ulusoy H, Merone G, Savini F, D'Ovidio C, Grazia UD, Furton K, Locatelli M. Fast off-line FPSE-HPLC-PDA determination of six NSAIDs in saliva samples. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1144:122082. [DOI: 10.1016/j.jchromb.2020.122082] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 01/08/2023]
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Locatelli M, Tartaglia A, D'Ambrosio F, Ramundo P, Ulusoy H, Furton K, Kabir A. Biofluid sampler: A new gateway for mail-in-analysis of whole blood samples. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1143:122055. [DOI: 10.1016/j.jchromb.2020.122055] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 10/24/2022]
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Tartaglia A, Ford T, Dodd-McCue D, Reid C, Hawley C, Hassell A. Charting Our Course: Chaplain Documentation as a Performance Improvement Project. J Health Care Chaplain 2017; 24:174-184. [PMID: 29095123 DOI: 10.1080/08854726.2017.1375885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article presents the results of a 30-month process improvement initiative examining the spiritual assessment documentation patterns of staff chaplains as well as CPE residents and interns at an academic medical center. Preliminary examination of chaplain documentation patterns led to a multidimensional intervention to address perceived documentation limitations and enhance reliability. The intervention resulted in positive changes in documentation patterns as assessed by an expert panel of experienced chaplains. Results offer opportunities for the use of electronic medical record documentation in training of chaplains.
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Affiliation(s)
| | - Timothy Ford
- a Virginia Commonwealth University , Richmond , Virginia
| | | | - Christine Reid
- a Virginia Commonwealth University , Richmond , Virginia
| | - Carolyn Hawley
- a Virginia Commonwealth University , Richmond , Virginia
| | - Alma Hassell
- a Virginia Commonwealth University , Richmond , Virginia
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Bongiovanni A, Foca F, Recine F, Fausti V, Riva N, Setola E, Faedi M, Ianniello A, Pieri F, Galassi R, Cavaliere D, Gardini A, Tartaglia A, Lunedei V, Mercatali L, Amadori D, Ibrahim T. Metastatic neuroendocrine neoplasia (mNEN) treatments in over 70 years (y) old patients: A retrospective outcome analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Dodd-McCue D, Tartaglia A, Myer K, Kuthy S, Faulkner K. Unintended Consequences: The Impact of Protocol Change on Critical Care Nurses' Perceptions of Stress. Prog Transplant 2016; 14:61-7. [PMID: 15077740 DOI: 10.1177/152692480401400110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context The Family Communication Coordinator protocol was implemented to facilitate effective communications during potential organ donation cases. Previous research records its effectiveness relative to donor outcome measures. By redefining and clarifying role responsibilities, the protocol may be associated with reduced job stress for those caring for potential donors. Objectives To determine the relationship of the Family Communication Coordinator protocol on the role stress of critical care nurses. To examine role stress in terms of role ambiguity, role conflict, and role overload within the context of potential organ donation cases. Design Retrospective nonexperimental descriptive design. Setting Critical care units of an academic teaching hospital. Participants Nineteen critical care nurses with experience before and after implementation of the Family Communication Coordinator protocol. Main Outcome Measures Job dimensions, role stress, job satisfaction, and commitment, measured using surveys. These data were supplemented with interviews and hospital records. Results The findings demonstrate that the Family Communication Coordinator protocol is associated with reduced role stress. More specifically, the nurses perceived significant reductions in role ambiguity and role conflict, and some reduction in role overload. The findings highlight high satisfaction with the protocol, as well as improved job satisfaction, and professional and organizational commitment. Conclusions The results suggest that reduced role stress among critical care nurses is associated with implementation of a protocol already associated with improved organ donation outcomes. The findings suggest positive outcomes also may impact other staff, multidisciplinary functions, and the organization. Similar protocols may be appropriate in other end-of-life situations to reduce uncertainty and stress among critical care professionals.
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Bongiovanni A, Recine F, Marcantognini G, Riva N, Fausti V, Liverani C, de vita A, Mercatali L, Foca F, Sansovini M, Pieri F, Oboldi D, Galassi R, Cavaliere D, Zaccaroni A, Tartaglia A, Lunedei V, Gardini A, Amadori D, Ibrahim T. Retrospective analysis of the efficacy of somatostatin analogs (SSA) in metastatic pulmonary neuroendocrine tumors and prognostic significance of FDG-PET. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw369.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
To improve organ donation performance, the Medical College of Virginia Hospitals implemented a comprehensive family support and communication program, consisting of a standard family communications protocol, a hospital-based team from the Department of Pastoral Care, targeted staff education, and an ongoing quality assurance measuring and monitoring system. The 3 best-demonstrated request practices, private setting, “decoupling,” and collaboration in the request between the organ procurement organization and hospital staff, were incorporated into the program. Improvement in the consent and donation rate was evident in the second calendar year of the program; the consent rate was 72% and the donation rate was 50%. During the second year, there was also a positive correlation between “decoupling,” appropriate requestor, and the consent rate. Implementation of a hospital-based team and a standard protocol facilitated the clarification of roles and responsibilities toward clearer and more consistent family communication and support. Data suggest that staff experience is a major contributor to a positive donation outcome.
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Affiliation(s)
- Alice Strozik Linyear
- Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Va
| | - Alexander Tartaglia
- Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Va
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Tartaglia A, Dodd-McCue D, Myer KA, Mullins A. Organ Donation in the 50+ Age Demographic. J Appl Gerontol 2016; 35:923-38. [PMID: 24752758 DOI: 10.1177/0733464814529843] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 03/09/2014] [Indexed: 11/16/2022] Open
Abstract
The rate of organ donation by older potential donors is significantly declining even though recent studies show positive clinical outcomes with organs transplanted from older donors. This study examined the 50+ age demographic to identify the rationale for donation decisions, preferred media methods of donation information delivery, and responsiveness to an age-tailored donation message. Results from 579 surveys, 87% from the 50+ age demographic, found respondents prone to self-select themselves as medically ineligible based on current medication and health status, even though they might be medically suitable donors. Their incentive to pursue additional information on donation is limited except when motivated by personal accounts within their families and communities. In addition, even when computer literate, they continue to favor the printed or spoken word for donation information delivery. The results suggest an opportunity for those working with older adults to develop more personalized, localized donation education programs targeting this age demographic.
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Saracino A, Tartaglia A, Trillo G, Muschitiello C, Bellacosa C, Brindicci G, Monno L, Angarano G. Late presentation and loss to follow-up of immigrants newly diagnosed with HIV in the HAART era. J Immigr Minor Health 2016; 16:751-5. [PMID: 23943015 DOI: 10.1007/s10903-013-9863-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To compare clinical characteristics and therapeutic management of newly HIV-diagnosed immigrants to natives. Patients with a first HIV diagnosis from 1996 to 2010 were included. Of 716 new diagnoses, 85 (12 %) were immigrants. Migrants were younger, more frequently females and sexually infected, less likely to voluntarily request testing, and less HCV-coinfected. Late presenters (CD4 <350 or AIDS) were 76 % among migrants versus 56 % in natives (p = 0.006) with an increasing trend over time. HAART was initiated in 76.5 % of natives and 72.4 % of immigrants; the number/type of adverse events and treatment discontinuation were similar. Immigrants received more NNRTIs-based regimens. A similar proportion of patients reached virological suppression at month 1-3-6 after HAART initiation, but 43 % of immigrants versus 27 % of natives resulted lost to follow-up (p < 0.001). Diagnosis of HIV was often delayed among migrants, who also presented a higher rate of lost to follow-up.
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Affiliation(s)
- A Saracino
- Clinic of Infectious Diseases, University of Foggia, Viale L. Pinto 1, 71100, Foggia, Italy,
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Dodd-McCue D, Tartaglia A. Role of “Relatedness” in Donation Discussions with Next of Kin: An Empirical Study of the Common Wisdom. Prog Transplant 2016; 15:249-56. [PMID: 16252631 DOI: 10.1177/152692480501500308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context Demographic similarities between support personnel and next of kin are of increasing interest. Studies examining like-race requestors have not produced clear and consistent outcomes. No studies have examined demographic relatedness factors for family support personnel who are not requestors. Objectives To examine the degree of “relatedness” between family communication coordinator chaplains and next of kin in cases that resulted in consent for donation. To examine “relatedness” in terms of demographic characteristics between primary hospital family support individuals and next of kin. Design Retrospective nonexperimental descriptive design spanning 1997 to 2004. Main Outcome Measures Demographic characteristics including gender, race and ethnicity, age, religion, and contact time. Results The results fail to support the hypothesis that the degree of “relatedness” between the family communicator and next of kin is associated with positive consent decisions. The findings show that gender is a shared quality in 60% of these cases, and race, age, and religion are even more infrequently shared qualities. The findings also suggest an elevated role of women in the donation discussion. Conclusions This study fills the void of empirical research through its use of objective outcome measures. The results fail to support the common wisdom and bring to question the foundation of many programs used to promote organ donation. Additionally, the findings emphasize the need for more rigorous investigations and development of more refined, valid measures for examining factors that may influence the donation discussion.
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Abstract
Background Recently published findings emphasize the dominant role of women in the donation discussion. With some noteworthy exceptions, the empirical literature on gender and donation, and the role of gender in healthcare decisions as well as donation, is limited. Objectives To provide preliminary information needed to begin theoretical or framework development and to initiate more rigorous research on the role of gender in donation discussions. Design This exploratory study is a descriptive qualitative retrospective study using focus group methodology. Setting and Participants Two focus groups were conducted in 2 major cities in the organ procurement organization's service area. Participants were women who were involved in the donation discussion within the past 5 years; 6 participated in 1 session, 8 in the other. Results The focus group discussions highlight the role of women in the donation process relative to information needs, information usage, and the ensuring dynamics of the donation discussion. Compared to men, women tend to seek more information and reframe this information for others. Because women are frequently central in family communication networks, they serve as a communication conduit for other family members and may influence others. Conclusions Involving key women decision makers in the early stages of the donation discussion and providing information elaboration build on women's central placement and role in family communication network processes. The significance of women's central placement may carry cultural implications, particularly for racial or ethnic groups with strong matriarchal or extended kinship structures.
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Affiliation(s)
- Diane Dodd-McCue
- Virginia Commonwealth University, Richmond, VA (DD-M, AT), LifeNet, Virginia Beach, VA (RC)
| | - Alexander Tartaglia
- Virginia Commonwealth University, Richmond, VA (DD-M, AT), LifeNet, Virginia Beach, VA (RC)
| | - Robin Cowherd
- Virginia Commonwealth University, Richmond, VA (DD-M, AT), LifeNet, Virginia Beach, VA (RC)
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Abstract
Background Previous research has examined the differences in organ donation consent rates between African Americans and other racial/ethnic groups. However, there is limited examination of whether differences exist between African American families that consent and those that do not. Objective To examine if there are significant differences between African American families that consent to donation compared to those that do not. Methods A random sample of 120 African American potential donor cases from an academic medical center between 1997 and 2004 were included in this study. Variables of interest included next-of-kin relationships, family interactions, knowledge of donor wishes, family initiation of the donation discussion, and satisfaction with the donation process. Results The data include 32 consent and 88 nonconsent cases. Compared to nonconsent cases, consent cases differed significantly in next-of-kin knowledge of donor wishes, frequent involvement of parents, and infrequent involvement of spouses. Donor wishes were known in 19% of consent cases but in none of the nonconsent cases. A parent was the dominant next-of-kin decision maker in 68% of consent cases, compared to 36% of nonconsent cases. A spouse assumed the dominant role in 29% of nonconsent cases but in only 6% of consent cases. Of these differences, wishes known, parental involvement, and spousal involvement were statistically significant ( P= .000, P= .002, and P= .013, respectively). Conclusions The results highlight the statistically significant differences between African American consent and nonconsent cases: knowledge of donor wishes and those involved in the donation decision. These results reinforce the importance of programs that encourage African American families to discuss donation with loved ones.
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Fitchett G, Tartaglia A, Massey K, Jackson-Jordon B, Derrickson PE. Education for Professional Chaplains: Should Certification Competencies Shape Curriculum? J Health Care Chaplain 2015; 21:151-64. [DOI: 10.1080/08854726.2015.1075343] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Tartaglia A, Dodd-McCue D, Ford T, Demm C, Hassell A. Chaplain Documentation and the Electronic Medical Record: A Survey of ACPE Residency Programs. J Health Care Chaplain 2015; 22:41-53. [DOI: 10.1080/08854726.2015.1071544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cotter JJ, Gendron T, Kupstas P, Tartaglia A, Will L. Perceived Benefits of Mobile Learning Devices for Doctoral Students in a School of Allied Health Professions. J Allied Health 2015; 44:e29-e35. [PMID: 26661706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 09/18/2015] [Indexed: 06/05/2023]
Abstract
Graduate students increasingly use personal electronic devices for learning but little is known about how they evaluate their benefits as mobile learning devices (MLDs). This study surveyed students in a hybrid distance education doctoral (PhD) program about their perceptions of the benefits of MLDs. Overall, the study found a range of opinions about the value of MLDs with about one-half of respondents finding benefits. Respondents emphasized that the MLDs improved motivation and productivity and that they were helpful in reviewing course-casts of on-campus sessions. Continued research is needed on doctoral education in general and the increasing use of innovations such as MLDs.
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Affiliation(s)
- J James Cotter
- Department of Gerontology, Virginia Commonwealth University, 730 East Broad St., Theater Row, 2nd Floor, Rm 2018, Richmond, VA 23298-0228, USA. Tel 804 828-1565 fax 804 828-5259.
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Imberti R, Ferrigno A, Tartaglia A, Rizzo V, Richelmi P, Vairetti M. Changes in extra- and intracellular pH in hepatocytes exposed to gabexate mesilate. Int J Immunopathol Pharmacol 2014; 27:365-70. [PMID: 25280027 DOI: 10.1177/039463201402700306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Gabexate mesilate (GM) is a synthetic inhibitor of plasmatic and pancreatic serine proteases licensed for the treatment of pancreatitis. Here we show that in suspensions of isolated hepatocytes, profound changes in extracellular, cytoplasmic, and vesicular pH occur after addition of GM. Isolated hepatocytes obtained by collagenase perfusion of rat liver were pre-incubated with 1, 2, and 4 mM GM. Extracellular pH (pH in the incubation medium) was measured by a conventional pH electrode, cytosolic and vesicular pH were measured by fluorescence changes of 2',7'-biscarboxyethyl-5,6-carboxyfluorescein acetoxymethyl ester (BCECF-AM) and fluorescein dextran, respectively. Incubation of hepatocytes with GM resulted in a dose-dependent decrease of extracellular pH. Cytosolic pH decreased rapidly and markedly in a dose-dependent manner during the first minutes and gradually returned towards baseline. Simultaneously, GM induced a rapid alkalinization of acidic vesicles. The presence of bis-(p-nitrophelyl) phosphate (BNPP), an esterase inhibitor, reduced the extent of extracellular acidification. Incubation of hepatocytes in the presence of dimethylamiloride, an Na+/H+ exchanger inhibitor, or in a sodium-free medium, did not modify the rate and extent of extracellular acidification. GM, a commercially available pharmacological agent, could be useful to manipulate extra- and intracellular pH.
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Affiliation(s)
- R Imberti
- Scientific Directorate, University of Pavia, Pavia, Italy
| | - A Ferrigno
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - A Tartaglia
- Department of Anesthesiology and Critical Care Medicine, University of Pavia, Pavia, Italy
| | - V Rizzo
- Department of Molecular Medicine, University of Pavia and Foundation IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - P Richelmi
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - M Vairetti
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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Abstract
OBJECTIVE This study examined citation patterns and indexing coverage from 2008 to 2010 to determine (1) the core literature of health care chaplaincy and (2) the resources providing optimum coverage for the literature. METHODS Citations from three source journals (2008-2010 inclusive) were collected and analyzed according to the protocol created for the Mapping the Literature of Allied Health Professions Project. An analysis of indexing coverage by five databases was conducted. A secondary analysis of self-citations by source journals was also conducted. RESULTS The 3 source journals--Chaplaincy Today, the Journal of Health Care Chaplaincy, and the Journal of Pastoral Care and Counseling--ranked as the top 3 journals in Zone 1 and provided the highest number of most frequently cited articles for health care chaplaincy. Additional journals that appeared in this highly productive zone covered the disciplines of medicine, psychology, nursing, and religion, which were also represented in the Zones 2 and 3 journals. None of the databases provided complete coverage for the core journals; however, MEDLINE provided the most comprehensive coverage for journals in Zones 1 and 2, followed by Academic Search Complete, CINAHL, PsycINFO, and ATLA. Self-citations for the source journals ranged from 9% to 16%. CONCLUSIONS Health care chaplaincy draws from a diverse body of inter-professional literature. Libraries wishing to provide access to journal literature to support health care chaplaincy at their institutions will be best able to do this by subscribing to databases and journals that cover medical, psychological, nursing, and religion- or spirituality-focused disciplines.
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Affiliation(s)
- Emily Johnson
- Tompkins-McCaw Library for the Health Sciences, Virginia Commonwealth University, Richmond, VA 23298-0582, USA.
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Tartaglia A, Fitchett G, Dodd-McCue D, Murphy P, Derrickson PE. Teaching research in clinical pastoral education: a survey of model practices. J Pastoral Care Counsel 2013; 67:5. [PMID: 24040698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The Association of Professional Chaplains (APC) developed Standards of Practice for Acute and Long-term settings. Standard 12 promotes research-literate chaplains as important for the profession. Since many chaplains receive training in clinical pastoral education (CPE) residency programs, the aim of this study was to identify model practices for the teaching of research in such programs. Using a purposeful sample, this study identified 11 programs that offered "consistent and substantive" education in research. Common features included the existence of a research champion, a culture supportive of research, and the availability of institutional resources. The study identified models and methodologies that CPE programs can adopt.
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Affiliation(s)
- Alexander Tartaglia
- School of Allied Health Professions, Virginia Commonwealth University, Richmond, VA, USA.
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Fitchett G, Tartaglia A, Dodd-McCue D, Murphy P. Educating chaplains for research literacy: results of a national survey of clinical pastoral education residency programs. J Pastoral Care Counsel 2012; 66:3. [PMID: 23045755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There is growing evidence that leaders in professional health care chaplaincy recognize the important role of research. The Standards of Practice recently approved by the Association of Professional Chaplains (APC), and especially the standard about research (Standard 12), provide strong evidence that the profession sees research, and research-literate chaplains, as important for its future. The aim of this study was to identify the extent to which Association for Clinical Pastoral Education, Inc (ACPE) accredited clinical pastoral education (CPE) residency programs are preparing their graduates to be the kind of research-literate chaplains described in these Standards. We interviewed CPE supervisors from 26 randomly-selected CPE residency programs. We found 12% of the programs had intentional and substantive research-related curricula, 27% of the programs offered some limited exposure to research, and 62% of the programs provided no education about research. We found also that supervisors often defined "research education" in terms of actually conducting research projects. CPE residency programs potentially play a central role in educating research-literate chaplains. Future research should examine the incentives and barriers that influence the inclusion of research education in CPE residency programs.
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Affiliation(s)
- George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA.
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Abstract
Measurement of student learning outcomes in clinical pastoral education has historically been assessed through student self-report instruments and subjective evaluation by CPE supervisors. Valid quantitative measurement is limited. This study utilizes standardized patients and a behavioral interview checklist to measure the impact of an initial summer unit of CPE training. Results demonstrate measurable change in student interview style behavior suggesting that simulation utilizing standardized patients is a valid objective measure of students' behavioral communication styles.
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Ferrara S, Tartaglia A, Santantonio T, Grisorio B. Role of HCV infection in the development of carotid atherosclerosis in a cohort of HIV-infected patients. J Int AIDS Soc 2010. [PMCID: PMC3112988 DOI: 10.1186/1758-2652-13-s4-p204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Silvani G, Buci L, Acquati S, Manini R, Gagliardi L, Tartaglia A. Abstract: P971 ROSUVASTATIN, LIPIDS AND INSULIN RESISTANCE IN TYPE 2 DIABETES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71092-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Saracino A, Scotto G, Tartaglia A, Fazio V, Cibelli D, Di Tullio R, Fornabaio C, Lipsi M, Angarano G. Low prevalence of HIV infection among immigrants within two months of their arrival in Italy. AIDS Patient Care STDS 2008; 22:691-2. [PMID: 18793084 DOI: 10.1089/apc.2008.0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Saracino
- Clinic of Infectious Diseases, University of Foggia, Italy
| | - G. Scotto
- Clinic of Infectious Diseases, University of Foggia, Italy
| | - A. Tartaglia
- Clinic of Infectious Diseases, University of Foggia, Italy
| | - V. Fazio
- Clinical Chemistry Laboratoy, OORR Hospital, Foggia, Italy
| | - D.C. Cibelli
- Clinic of Infectious Diseases, University of Foggia, Italy
| | - R. Di Tullio
- Clinic of Infectious Diseases, University of Foggia, Italy
| | - C. Fornabaio
- Clinic of Infectious Diseases, University of Foggia, Italy
| | - M.R. Lipsi
- Clinical Chemistry Laboratoy, OORR Hospital, Foggia, Italy
| | - G. Angarano
- Clinic of Infectious Diseases, University of Foggia, Italy
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Saracino A, Monno L, Punzi G, Cibelli DC, Tartaglia A, Scudeller L, Brindicci G, Lagioia A, Scotto G, Angarano G. HIV-1 biological phenotype and predicted coreceptor usage based on V3 loop sequence in paired PBMC and plasma samples. Virus Res 2007; 130:34-42. [PMID: 17582634 DOI: 10.1016/j.virusres.2007.05.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 03/26/2007] [Accepted: 05/09/2007] [Indexed: 10/23/2022]
Abstract
Paired PBMCs and plasma samples from 34 HIV-infected patients were studied to verify the relationship between coreceptor use based on genotyping of V3 region of HIV-1 envelope gp120 and biological phenotype with virus isolation and subsequent correlation to clinical characteristics. The "11/25" rule, geno2pheno and PSSM were compared. All SI patients were HIV-1 subtype B (p=0.04) and had a lower CD4 count than NSI patients (p=0.01), while no differences were observed in mean HIV-RNA (log) (p=0.6). SI phenotype was not associated with AIDS-defining events (p=0.1) or with concurrent antiretroviral therapy (p=0.4). With geno2pheno, which shows the highest sensibility (83%), an X4 or X4/R5 genotype in PBMC DNA was also associated to B-subtype and lower CD4 count (p=0.01) compared to R5 isolates. Based on plasma RNA sequences, the predicted coreceptor usage agreed with PBMC DNA in 79% of cases with the "11/25" rule, 82% with geno2pheno, and 82% with PSSM. A X4 virus in plasma (but not in PBMCs) was significantly associated with HAART in all three methods (p=0.01 for "11/25" rule, p=0.01 for geno2pheno and p=0.03 for PSSM). Due to viral mixtures and/or difficulties in genotype interpretation, current V3 sequence-based methods cannot accurately predict HIV-1 coreceptor use.
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Affiliation(s)
- A Saracino
- Clinic of Infectious Diseases, University of Foggia, Italy
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Demichelis F, Giordana A, Tartaglia A. Molecular dynamics in H2O and D2O analysis by inelastic scattering of 10 Å neutrons. ACTA ACUST UNITED AC 2007. [DOI: 10.1007/bf02726316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Acquati S, Silvani G, Bondi A, Cicognani R, Bondi G, Gagliardi L, Vacirca A, Tartaglia A, Camporesi C, Mazzeo V, Nizzoli M. PO22-717 BEYOND GLYCATED HAEMOGLOBIN: EFFECTIVENESS OF ROSIGLITAZONE IN TYPE-2 DIABETES WITH HYPERTENSION AND NON-ALCOHOLIC FATTY LIVER. A RANDOMIZED CONTROLLED ONE-YEAR STUDY. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71727-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Silvani G, Acquati S, Tartaglia A, Bondi A, Gagliardi L, Vacirca A, Nizzoli M. PO23-787 ROSUVASTATIN (RSV)-INDUCED IMPROVEMENT OF INSULIN-RESISTANCE AND GLYCAEMIC CONTROL IN TYPE-2 DIABETIC PEOPLE IS NOT ONLY TRIGLYCERIDE (TG)-RELATED. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
This review article provides insight into the evolution of professional healthcare chaplaincy. It identifies key historical developments identifying the training, qualifications, and competencies of chaplains. Consideration is given to both the unique character of the pastoral role in healthcare as well as the contribution of chaplains to the interdisciplinary care of patients and families. The article points to the emerging need for chaplains to pursue research within the clinical context.
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Affiliation(s)
- Tim Ford
- Department of Pastoral Care, Program in Patient Counseling, Virginia Commonwealth University Health System, Richmond, VA, USA.
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Saracino A, Monno L, Scudeller L, Cibelli DC, Tartaglia A, Punzi G, Torti C, Lo Caputo S, Mazzotta F, Scotto G, Carosi G, Angarano G. Impact of unreported HIV-1 reverse transcriptase mutations on phenotypic resistance to nucleoside and non-nucleoside inhibitors. J Med Virol 2006; 78:9-17. [PMID: 16299731 DOI: 10.1002/jmv.20500] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An extended spectrum of HIV-1 reverse-transcriptase (RT) mutations in HAART-treated patients has been recently described. To verify the possible association of previously unreported RT mutations with a decrease of phenotypic susceptibility to nucleoside (NRTIs) and non-nucleoside (NNRTIs) RT inhibitors, the RT sequence of 328 HIV-1-positive patients (102 naïve and 226 treated with HAART participating in either the PhenGen or Genpherex study) was analyzed. All treated patients were tested at the time of therapeutic failure with both phenotypic (Antivirogram, Virco) and genotypic analyses (VircoGen); the frequency of RT substitutions (positions 1-240) with respect to consensus B was compared to that of naïve patients using a Chi-square test. Amino acid changes at 13 positions not included in the IAS list of resistance-associated mutations were detected more frequently in treated than in naïve subjects. The mutations involving 10 of these positions were associated with a reduced susceptibility to antiretroviral drugs; K20R, T39A, K43EQN, E203KD, H208Y, and D218E were correlated with NRTI resistance while mutations K101EQP, H221Y, K223EQ, L228HR were associated to NNRTI resistance. A correlation was found between K20R and lamivudine resistance (P = 0.006) while T39A (P = 0.005), K43EQN (<0.001), E203KD (P = 0.010), and H208Y (P = < 0.001) seemed to be associated with a previous use of zidovudine and stavudine and with the development of thymidine analog resistance. For H208Y, an association with use/resistance to abacavir (P = 0.004) was also noted. D218E showed a weak association to didanosine resistance (P = 0.013). The data confirm that previously unreported mutations are associated with antiretroviral drug experience and, more importantly, with a reduced susceptibility to NRTIs and NNRTIs.
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Affiliation(s)
- A Saracino
- Clinic of Infectious Diseases, University of Foggia, Foggia, Italy
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Saracino A, El-Hamad I, Prato R, Cibelli DC, Tartaglia A, Palumbo E, Pezzoli MC, Angarano G, Scotto G. Access to HAART in HIV-infected immigrants: a retrospective multicenter Italian study. AIDS Patient Care STDS 2005; 19:599-606. [PMID: 16164386 DOI: 10.1089/apc.2005.19.599] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Since 1996, AIDS has declined in the Italian population, but cases in foreign patients, including both recent immigrants and long-term residents, have increased from 3.9% in 1995-1996 to 15.4% in 2001-2002. This increase can only be partly explained by a higher migratory flow and might reflect a delayed access to health facilities and to antiretroviral therapy in migrants. We performed a survey for the year 2003 of HIV-infected immigrants to Italy from countries outside the European Union to verify which factors might influence a lack of access to highly active antiretroviral therapy (HAART). Italian centers of infectious diseases were requested to send sociodemographic and clinical data of HIV-infected immigrant patients. A total of 553 HIV-infected immigrants (49.9% women) were evaluated, representing 6.5% of all HIV-infected patients from these centers. The mean duration of residency in Italy was 6.6 +/- 5.0 years. The country of origin was Africa (64.5%), North and South America (24.2%), Eastern Europe (7.0%), and Asia (3.8%). A total of 407 of 553 patients (73.6%) were taking antiretroviral drugs at the time of screening. Females presented a younger age (p = 0.001), a lower frequency of Centers for Disease Control (CDC) stage B/C (p = 0.008) and a more frequent heterosexual exposure to HIV (p < 0.001), while no differences were observed for time of first positive serology (p = 0.7). CD4 cell count (p = 0.9) and log plasma HIV-RNA (p = 0.1). Characteristics of HAART patients were compared to those of nontreated patients, despite a CD4 cell count less than 350 cells/mm(3). No significant difference was found for gender, country of origin, risk factor, and years of Italian residence, while legal immigrants (p = 0.018) and registered in the National Health Service (p = 0.014) were significantly more likely to receive HAART compared to illegal immigrants.
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Affiliation(s)
- A Saracino
- Clinic of Infectious Diseases, University of Foggia, v.le L Pinto, 1-71100 Foggia, Italy.
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La Torre G, De Vito E, Barra M, Masala D, Tartaglia A, Mannocci A, Ricco A, Capelli G, Ricciardi G. [Applicability of the new law of State and Regional Agreement on management of swimming pools]. Ann Ig 2005; 17:281-8. [PMID: 16156387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The Authors carried out a survey on private and public managers of 80 Italian swimming pools to evaluate the hygienic aspects and safety of the swimming pools. Participants were submitted to a set of questions about the modifications recently brought to the Act on management of the swimming pools during 2003. The study showed a poor knowledge about the hygienic-safety parameters, in particular of chlorine doses, range of temperature and frequency of daily turnover of the swimming pool water. The respect of chemical-physical parameters is necessary not only to assure an adequate microbial control of the water, but also to reduce the production of irritant and potentially toxic substances. The Authors pointed out the need of greater attention to hygienic aspects in order to reduce health risks, deriving from an uncorrected application of the laws, and to provide a greater comfort to the users of swimming pools.
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Affiliation(s)
- G La Torre
- Laboratorio di Epidemiologia e Biostatistica, Istituto di Igiene, Università Cattolica, Roma.
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Abstract
OBJECTIVE The study examined the impact of a protocol directed at increasing organ donation on the role stress and work attitudes of critical care nurses involved in potential organ donation cases. The research examined whether the protocol could positively affect nurses' perceptions of role stress, and if so, could the work environment improvements be sustained over time. BACKGROUND The Family Communication Coordinator (FCC) protocol promotes effective communication during potential organ donation cases using a multidisciplinary team approach. Previous research found it associated with improved donation outcomes and with improved perceptions of role stress by critical care nurses. However, the previous study lacked methodological rigor necessary to determine causality and sustainability over time. METHODS The study used a quasi-experimental prospective longitudinal design. The sample included critical care nurses who had experience with potential organ donation cases with the protocol. Survey data were collected at 4 points over 2 years. Surveys used previously validated and reliable measures of role stress (role ambiguity, role conflict, role overload) and work attitudes (commitment, satisfaction). Interviews supplemented these data. RESULTS The nurses' perceptions of role stress associated with potential organ donation cases dramatically dropped after the protocol was implemented. All measures of role stress, particularly role ambiguity and role conflict, showed statistically significant and sustained improvement. Nurses' professional, unit, and hospital commitment and satisfaction reflect an increasingly positive workplace. CONCLUSIONS The results demonstrate that the FCC protocol positively influenced the workplace through its impact on role stress over the first 2 years following its implementation. The findings suggest that similar protocols may be appropriate in improving the critical care environment by reducing the stress and uncertainty of professionals involved in other end-of-life situations. However, the most striking implication relates to the reality of the workplace: meeting the goals of improved patient care outcomes and those of improving the healthcare work environment are not mutually exclusive and may be mutually essential.
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Affiliation(s)
- Diane Dodd-McCue
- Program in Patient Counseling, Virginia Commonwealth University, Richmond, VA, USA.
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Tartaglia A, McMahon BT, West SL, Belongia L. Workplace discrimination and disfigurement: the national EEOC ADA research project. Work 2005; 25:57-65. [PMID: 16006676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with disfigurement is documented. Key dimensions of workplace discrimination involving Americans with disfigurement and persons with missing limbs are compared and contrasted. Specifically, the researchers examine demographic characteristics of Charging Parties; the industry designation, location and size of Respondents/employers; the discrimination Issue (i.e., type of adverse action) alleged to occur; and the legal outcome or Resolution of these allegations. Charging Parties with disfigurement who are female or between 30 and 39 years of age are more likely to encounter employment discrimination than their counterparts with missing limbs. Harassment and Non-wage Benefits are the Issues that emerge in higher proportion. Allegations derived from persons with disfigurement are more common in among mid-size employers, those located in the South, or those in Retail or Service industries. Following investigation, allegations derived from persons with disfigurement are less likely to have Merit Resolutions than those brought by Charging Parties with missing limbs.
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Affiliation(s)
- Alexander Tartaglia
- Program in Patient Counseling, Virginia Commonwealth University, Richmond, 23298, USA
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Dodd-McCue D, Tartaglia A. The impact of the Family Communication Coordinator (FCC) Protocol on the role stress of hospital chaplains. J Pastoral Care Counsel 2005; 59:345-60. [PMID: 16392645 DOI: 10.1177/154230500505900404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The Family Communication Coordinator (FCC) Protocol was implemented to provide early family intervention and to facilitate effective communications during potential organ donation cases. Previous studies found the Protocol associated with improved donor outcome measures and with reduced role stress for ICU nurses caring for potential donors. The present study examines the impact of the Protocol on the perceived role stress of hospital chaplains serving as FCCs. All hospital chaplains serving as FCCs at an academic teaching hospital were surveyed. Their perceptions of job dimensions, role stress, job satisfaction, and commitment were measured; interviews and secondary data supplemented the surveys. The findings demonstrate that the FCC Protocol is associated with improved role stress, specifically role ambiguity and role conflict, among hospital chaplains serving as FCCs. Additionally, the findings suggest that satisfaction with the Protocol may be associated with experience with the Protocol.
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Affiliation(s)
- Diane Dodd-McCue
- School of Allied Health Professions, Virginia Commonwealth University, Richmond, VA 23298-0233, USA
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