Elisabetta Angelino

Agitation assessment in severe traumatic brain injury: methodological and clinical issues

The aim of this single case study was to evaluate the applicability of a graphic and statistical time-series analyses in the observation of an agitation disturbance in a 16-year-old patient who had sustained a severe traumatic brain injury. The agitation was measured using the Agitated Behaviour Scale. The experimental model was of the A-B type: phase A corresponded to the period of vegetative state, and phase B to the period following the reawakening from coma. The data were submitted to visual and statistical analysis by the split-middle trend line method, function of autocorrelation, and C statistic. The results show the different nature and frequency of the agitated behaviour during the vegetative state and after reawakening from coma. The application of a statistical analysis to establish whether the behavioural disturbance is random or a response to the environment allows the adoption of specific and potentially more efficacious treatments.

Type A and Cardiovascular Responsiveness in Italian Blue Collar Workers

Since great importance is attached in behavioral medicine and in health psychology to problems of prevention, it is only right that one of the most explored areas should be the assessment of psychosocial coronary risk factors. The best known of these factors is probably the Type A behavior pattern (TABP), a construct defined as the outcome of a person—situation interaction that emerges in certain individuals in appropriately stressful or challenging situations (Friedman & Rosenman, 1959). Since the TABP has come into use, there have been a host of studies clarifying the construct, its modes of assessment, and its association with the development of coronary heart disease (CHD). These studies have generated two metaanalyses (Booth-Kewley & Friedman, 1987; Matthews, 1988), which lead to the conclusion that the linkage between Type A and CHD is not particularly strong and may be considered meaningful only for certain populations and with certain modes of assessment. Both find that the strength of the linkage between TABP and CHD varies with the tools of assessment—significant if the assessment is conducted with the structured interview (SI), but less so with self-report inventories (Houston, 1988). It also appears that the value of the SI as predictor is proven in cross-sectional researches and in population-based prospective studies, but is drastically reduced in studies conducted on high-risk populations.

What constitutes the ‘Minimal Care’ interventions of the nurse, physiotherapist, dietician and psychologist in Cardiovascular Rehabilitation and secondary prevention: A position paper from the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology

Background In cardiovascular prevention and rehabilitation, care activities are carried out by different professionals in coordination, each with their own specific competence. This GICR–IACPR position paper has analysed the interventions performed by the nurse, physiotherapist, dietician and psychologist in order to identify what constitutes minimal care, and it lists the activities that are fundamental and indispensable for each team member to perform in clinical practice. Results In analysing each type of intervention, the following dimensions were considered: the level of clinical care complexity, determined both by the disease and by environmental factors; the ‘area’ complexity, i.e. the specific level of competence required of the professional in each professional section; organisational factors, i.e. whether the care is performed in an inpatient or outpatient setting; duration of the rehabilitation intervention. The specific contents of minimal care have been identified for each professional area together with the specific goals, the assessment tools and the main essential interventions. For the assessments, only a few validated tools have been indicated, leaving the choice of which instrument to use to the individual professional based on experience and usual practice. Conclusion For the interventions, attention has been focused on conditions of major complexity requiring special care, taking into account the different care settings, the clinical conditions secondary to the disease event, and the distinct tasks of each area according to the operators specific role. The final report performed by each professional has also been included.