A retrospective study exploring parents' perceptions of their child's assessment

The current study investigates parents' perceptions of their child's assessment, focusing on their responses to the Italian version of the Parents' Experience of Assessment Scale (QUEVA-G). Twenty parents, who voluntarily agreed to be contacted after completing the questionnaire, participated in qualitative interviews to gain deeper insights into their assessment experiences. A thematic analysis was conducted on the interview transcriptions, highlighting three primary domains of parental experience: (1) parental perceptions of the assessment process; (2) effects of the assessment; and (3) parental perceptions of their relationship with their children's teachers. The findings indicate that the QUEVA-G accurately captures most areas of interest as well as reveals unexplored aspects.

Phenotyping congestion in patients with acutely decompensated heart failure with preserved and reduced ejection fraction: The Decongestion duRing therapY for acute decOmpensated heart failure in HFpEF vs HFrEF- DRY-OFF study

AIMS

To evaluate pulmonary and intravascular congestion at admission and repeatedly during hospitalization for acute decompensated heart failure (ADHF) in HFrEF and HFpEF patients using lung (LUS) and inferior vena cava (IVC) ultrasound.

METHODS AND RESULTS

Three-hundred-fourteen patients (82±9 years; HFpEF =172; HFrEF=142) admitted to Internal Medicine wards for ADHF were enrolled in a multi-center prospective study. At admission HFrEF presented higher indexes of pulmonary and intravascular congestion (LUS-score: 0.9 ± 0.4 vs 0.7 ± 0.4; p<0.01; IVC end-expiratory diameter: 21.6 ± 5.1 mm vs 20±5.5 mm, p<0.01; IVC collapsibility index 24.4 ± 17.4% vs 30.9 ± 21.1% p<0.01) and higher Nt-proBNP values (8010 vs 3900 ng/l; p<0.001). At discharge, HFrEF still presented higher B-scores (0.4 ± 4 vs 0.3 ± 0.4; p = 0.023), while intravascular congestion improved to a greater extent, thus IVC measurements were similar in the two groups. No differences in diuretic doses, urine output, hemoconcentration, worsening renal function were found. At 90-days follow up HF readmission/death did not differ in HFpEF and HFrEF (28% vs 31%, p = 0,48). Residual congestion was associated with HF readmission/death considering the whole population; while intravascular congestion predicted readmission/death in the HFrEF, no association between sonographic indexes and the outcome was found in HFpEF.

CONCLUSIONS

Serial assessment of pulmonary and intravascular congestion revealed a higher burden of fluid overload in HFrEF and, conversely, a greater reduction in intravascular venous congestion with diuretic treatment. Although other factors beyond EF could play a role in congestion/decongestion patterns, our data may be relevant for further phenotyping HF patients, considering the importance of decongestion optimization in the clinical approach.

A prototype of an adjustable advanced reciprocating gait orthosis (ARGO) for spinal cord injury (SCI)

OBJECTIVE

To develop a reciprocating gait orthosis which could be used in different sized patients.

DESIGN

Clinical trial and orthotic development.

SETTING

A large rehabilitation hospital in Rome, Italy

PATIENTS AND METHODS

To carry out this project normal reciprocating gait orthosis parts were used. The device was modified to adjust the hip-ankle height, and the hip-hip distance. It was tested, by five patients already walking with standard ARGO, to evaluate the performances of the orthosis. The device has been tested on seven newly injured patients fulfilling specific criteria of different height and weight.

MAIN OUTCOME MEASURES

Prototype suitability; patients appreciation.

RESULTS

The device can be used for persons between 1.60 m and 1.85 m tall, weighing up to 100 kg. The orthosis allows an upright position without the use of the hands, and walking with a walker or with two canes. The foot orthosis cover sizes 36-40 (British 3-7) and 41-45 (British 7-11). With the exception of donning, doffing and lifting, the walking performances of the prototype and the general appreciation is comparable with those of a standard device. After a short period of training all seven patients were able to walk in the parallel bars. All of them expressed general appreciation for the device; despite this only four patients wanted the orthosis, two refused it and one has not decided yet.

CONCLUSIONS

The prototype allows the same standing and walking performances of normal ARGO. It could be used in spinal cord injury patients to let them test the potential of the device and thus be useful in the effort to reduce the percentage of ARGO rejection.