Alba malara - Academia.edu (original) (raw)

Papers by Alba malara

International Journal of Obesity, 2004

OBJECTIVE: To investigate the role of phospholipase C (PLC), phospholipase A 2 (PLA 2), calcium, ... more OBJECTIVE: To investigate the role of phospholipase C (PLC), phospholipase A 2 (PLA 2), calcium, and protein kinase C (PKC) in mediating leptin-enhanced aggregation of human platelets. DESIGN: In vitro, ex vivo study.

Rejuvenation Research

COVID-19 may have a heterogeneous onset, especially in older age. However, whether and how COVID-... more COVID-19 may have a heterogeneous onset, especially in older age. However, whether and how COVID-19 signs and symptoms may present and aggregate together according to sociodemographic and health factors is unclear, as well as their prognostic value. This study included 981 COVID-19 inpatients who participated in the Gero-Covid Observational study. Signs/symptoms at disease onset, sociodemographic, health, cognitive status, and mobility were systematically recorded. Clusters of signs/symptoms were identified through agglomerative hierarchical clustering. The associations of single signs/symptoms and symptom clusters with longer hospitalization (‡16 days) and in-hospital mortality were explored through logistic and Cox regressions. The signs/symptoms most reported in our sample (age 78.3-9.39 years; 49.4% women) were fever (62.5%), cough (45.5%), and dyspnea (62.7%). Atypical symptoms were reported by up to one-third of patients, and delirium by 9.1%. Atypical symptoms were more frequent with advancing age and with lower pre-COVID-19 cognitive and mobility levels. Older men more likely reported respiratory symptoms than women. Dyspnea (hazard ratio [HR]

Aging Clinical and Experimental Research

Background Nursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Lim... more Background Nursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Limited data are available on vaccine-induced immunity and on the protection ensured by a prior infection in this population. Aims The present study aims to monitor antibody levels and their persistence over a 6-month period in NH residents according to the history of prior SARS-CoV-2 infection. Methods We measured anti-trimeric Spike IgG antibody levels in a sample of 395 residents from 25 NHs in 6 Italian Regions at study enrolment (prior to the first dose of vaccine, T0) and then after 2 (T1) and 6 months (T2) following the first vaccine dose. All participants received mRNA vaccines (BNT162b2 or mRNA-1273). Analyses were performed using log-transformed values of antibody concentrations and geometric means (GM) were calculated. Results Superior humoral immunity was induced in NH residents with previous SARS-CoV-2 infection. (T0: GM 186.6 vs. 6.1 BAU/ml, p < 0.001; T1: GM 5264.1 vs. 944...

Magnesium research : official organ of the International Society for the Development of Research on Magnesium, 2001

We performed this study to investigate whether alpha- and beta-adrenergic agonists are able to re... more We performed this study to investigate whether alpha- and beta-adrenergic agonists are able to regulate intracellular free magnesium concentrations [Mg2+]i in platelets from healthy and obese individuals. Twenty-six informed-consent men (14 healthy and 12 obese) were enrolled in the study. We measured fasting plasma glucose, insulin, epinephrine and norepinephrine. Platelet [Mg2+]i at the baseline and after stimulation with clonidine or isoproterenol was measured by fluorescent probe mag-fura-2. In platelets from healthy subjects, alpha-adrenergic stimulation by clonidine led to a dose-dependent decrease in [Mg2+]i (basal: 245 +/- 39 microM; clonidine 5 pg/mL: 109 +/- 27 microM, p < 0.05; clonidine 10 pg/mL: 77 +/- 26 microM, p < 0.01), while no significant change in platelet [Mg 2+]i was detected in obese men. Furthermore, the co-incubation with clonidine (10 pg/mL) and yohimbine (50-100 pg/mL) completely abated the effect of clonidine on [Mg2+]i in platelets from healthy ind...

ABSTRACT OBJECTIVE: Type 2 Diabetes mellitus may affect the humoral immune response following ... more ABSTRACT OBJECTIVE: Type 2 Diabetes mellitus may affect the humoral immune response following vaccinations, but data concerning COVID-19 vaccines are scarce. We evaluated the impact of diabetes mellitus on antibody response to the SARS-CoV-2 vaccination in older long-term care facilities (LTCF) residents and tested for differences according to anti-diabetic treatment. RESEARCH DESIGN AND METHODS: 555 older LTCF residents participating in the GeroCovid Vax study were included for this analysis. SARS-CoV-2 trimeric S Immunoglobulin G (anti-S-IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2- and 6-months. The impact of diabetes on anti-S-IgG levels was evaluated using linear mixed models, which included the interaction between time and the presence of diabetes. A second model considered also diabetes treatment: no insulin therapy (including dietary only or use of oral anti-diabetic agents) and insulin therapy (alone or in combination wi...

Reports

Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomat... more Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 s...

International Journal of Environmental Research and Public Health

Dementia was one of the conditions focused on in an EU (European Union) project called “PARADISE”... more Dementia was one of the conditions focused on in an EU (European Union) project called “PARADISE” (Psychosocial fActors Relevant to brAin DISorders in Europe) that later produced a measure called PARADISE 24, developed within the biopsychosocial model proposed in the International Classification of Functioning Disability and Health (ICF). The aims of this study are to validate PARADISE 24 on a wider sample of patients with mild to moderate dementia to expand PARADISE 24 by defining a more specific scale for dementia, by adding 18 questions specifically selected for dementia, which eventually should be reduced to 12. We enrolled 123 persons with dementia, recruited between July 2017 and July 2019 in home care and long-term care facilities, in Italy, and 80 participants were recruited in Warsaw between January and July 2012 as part of a previous cross-sectional study. The interviews with the patient and/or family were conducted by health professionals alone or as a team by using the P...

$Research paper thumbnail of EUPRON : nurses\u2019 practice in interprofessional pharmaceutical care in Europe: a cross-sectional survey in 17 countries$

Objectives Safe pharmaceutical care (PC) requires an interprofessional team approach, involving p... more Objectives Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses' roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses' practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists. Design A cross-sectional survey. setting The study was conducted in 17 European countries, each with their own health systems. Participants Pharmacists, physicians and nurses with an active role in PC were surveyed. Main outcome measures Nurses' involvement in PC, experiences of interprofessional collaboration and communication and views on nurses' competences. results A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses' involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. Conclusions ME, MMA, PEI and prescribing are part of nurses' activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.

BMC Geriatrics, 2022

Background In older and multimorbid patients, chronic conditions may affect the prognostic validi... more Background In older and multimorbid patients, chronic conditions may affect the prognostic validity of computed tomography (CT) findings in COVID-19. This study aims at assessing to which extent CT findings have prognostic implications in COVID-19 older patients. Methods Hospitalized COVID-19 patients aged 60 years or more enrolled in the multicenter, observational and longitudinal GeroCovid study who underwent chest CT were included. Patients were stratified by tertiles of age and pneumonia severity to compare CT findings. Hierarchical clustering based on CT findings was performed to identify CT-related classificatory constructs, if any. The hazard ratio (HR) of mortality was calculated for individual CT findings and for clusters, after adjusting for potential confounders. Results 380 hospitalized COVID-19 patients, with a mean age of 78 (SD:9) years, underwent chest CT scan. Ground glass opacity (GGO), consolidation, and pleural effusion were the three most common CT findings, wit...

Vaccine, 2022

The COVID-19 pandemic has changed routine care practice for older persons, especially in those wi... more The COVID-19 pandemic has changed routine care practice for older persons, especially in those with frailty living in long term care (LTC) facilities. Due to the high mortality rates of Nursing home (NH) residents during the first wave of the COVID-19 pandemic, priority for COVID-19 vaccinations was given to this vulnerable population. However, the safety and efficacy of such vaccines in older frail elders remains questionable due to the fact that initial randomized clinical trials (RCTs) for such vaccines did not include this population. This type of discrimination in patient participation in RCTs continues and has been recognized in the literature. Nevertheless, in the context of a worldwide emergency, COVID-19 vaccination in older persons living in LTC facilities may provide a solid basis to protect against negative outcomes, such as COVID-19 infection and death. In this report, we present the protocol of the GeroCovid Vax study, an Italian study that began in February 2021 which is aimed at investigating the safety and efficacy of the anti-SARS-CoV-2 vaccinations in older persons living in LTCs. This protocol specially aims to continuously and closely monitor events related to- and following- the anti-SARS-CoV-2 vaccination in elderly living in LTC facilities. In this report, we will provide information related to the study protocol and describe baseline characteristics of the sample.

PLOS ONE, 2021

Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potenti... more Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC). Design Qualitative study conducted through semi-structured in-depth interviews. Setting Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results 340 interviews were completed. Several tasks were described within four potential nursing responsibil...

International Journal of Environmental Research and Public Health, 2021

Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is ... more Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses’ responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC and to investigate nurses’ level of responsibility. A framework of PC tasks and contextual factors was developed based on literature review and previous DeMoPhaC project results. Tasks and context were cross-sectionally evaluated using an online survey in 14 European countries. A total of 923 nurses, 240 physicians and 199 pharmacists responded. The majority would consider nurses responsible for tasks within: medication self-management (86–97%), patient education (85–96%), medication safety (83–95%), monitoring adherence (82–97%), care coordination (82–95%), and drug monitoring (78–96%). The most prevalent level of responsibility was ‘with...

BACKGROUND Nurses play an important role in pharmaceutical care. They are involved in: detecting ... more BACKGROUND Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To date, a framework of nurses' competences on knowledge, skills, and attitudes as to interprofessional pharmaceutical care tasks is missing. OBJECTIVES To reach agreement with experts about nurses' competences for tasks in interprofessional pharmaceutical care. METHODS A two-phase study starting with a scoping review followed by five Delphi rounds was performed. Competences extracted from the literature were assessed by an expert panel on relevance by using the RAND/UCLA method. The experts (n = 22) involved were healthcare professionals, nurse researchers, and educators from 14 European countries with a specific interest in nurses'...

Gerontology, 2021

Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that ... more Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients’ care cohort. The present study aims to evaluate whether outpatient and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective status, perceived well-being, and personal capabilities of outpatients and home care patients with cognitive disorders. Methods: Prospectively recorded patients in an electronic web registry provided by BlueCompanion Ltd. Up to October 31, 2020, the sample included 90 patients receiving regular care from the Center for Cognitive Disorders and Dementia in Catanzaro Lido, Italy. It was made of 52 ambulatory outpatients and 38 home care patients, mean age 83.3 ± 7.54 years. Participants underwent a multidimensional assessment at baseline (T0) and after 90 days (T1). For each patient, we administered the Mini-Mental State Examination (MMSE) for c...

Aging Clinical and Experimental Research, 2021

Advances in Health and Behavior, 2021

Following the rapid spread of a new Coronavirus identified in China, on 30.01.2020, the World Hea... more Following the rapid spread of a new Coronavirus identified in China, on 30.01.2020, the World Health Organization (WHO) declares a state of public health emergency of international importance and in Italy health surveillance measures are promptly strengthened. The aim of the study is to describe the surveillance system for the spread of the epidemic and how the surveillance contributes to the monitoring system and to the regional weekly risk classification.

Journal of the American Medical Directors Association, 2021

The burden of COVID-19 in long-term care facilities (LTCFs) was high worldwide. According to an I... more The burden of COVID-19 in long-term care facilities (LTCFs) was high worldwide. According to an Italian national survey, during the first pandemic wave, of the 33.8% of residents who died with COVID-19elike symptoms, only 7.4% had tested positive to a SARS-CoV-2 swab test because of limitations in accessing diagnostic tests. 1 The prevalence of frailty, multimorbidity, and dementia, 2,3 as well as the frequent atypical or asymptomatic manifestations of COVID-19 in such populations, 4 were some of the factors that contributed to the spread of the infection in this setting. The picture was further complicated by the fact that a substantial number of residents suffered from conditions that mimic SARS-CoV-2 infection. 5 In this study, we aimed to investigate the clinical features associated with SARS-CoV-2 infection and mortality due to COVID-19 in Italian LTCFs. A prospective study with a 60-day follow-up was performed in a sample of Italian LTCFs, from March 1, 2020, up to December 31, 2020, as part of the GeroCovid Observational study, a multicenter and multisetting study, evaluating the impact of the COVID-19 pandemic on the health of individuals aged !60 years in acute, outpatient, and LTC settings. 6 The GeroCovid cohort consists of 39 LTCFs from 6 Italian regions, 9 of which reported positive COVID-19 cases. The total number of residents in the facilities involved was 2380; of these, a subsample of 586 aged !60 years was enrolled based on the presence of signs and symptoms suspect for COVID-19 or on a judgment of high risk of infection. The residents who had a direct physical contact or a stay in a closed environment with a COVID-19econfirmed case with no suitable personal protective equipment (close contact) were considered at high risk of infection. Furthermore, all new patients admitted to a facility and all residents readmitted after a hospital stay were also considered at high risk of infection. The residents at high risk or with COVID-19elike symptoms underwent SARS-CoV-2 swab testing. Based on the swab results and the above risk factors of infection, we categorized the residents into 3 groups: (1) positive SARS-CoV-2 swab; (2) negative SARS-CoV-2 swab with close contact (asymptomatic); and (3) negative SARS-CoV-2 swab with clinical suspicion (symptomatic). For each participant, we collected data on demographic characteristics, lifestyle, chronic diseases, and clinical outcome in an electronic registry. 7 These characteristics were compared among the 3