The management of chronic diseases requires personalized healthcare that allows older adults to manage their diseases at home. This systematic review aimed to describe the smart home technologies used in the management of chronic diseases in older people. A systematic literature review was conducted on four databases and was reported following the PRISMA statement. Nineteen articles were included. The intervention technologies were classified into three groups: smart home, characterized by environmental sensors detecting motion, contact, light, temperature, and humidity; external memory aids, characterized by a partnership between mobile apps and smart home-based activity learning; and hybrid technology, with the integration of multiple technologies, such as devices installed at patients’ homes and telemedicine. The health outcomes evaluated are vital signs, medication management, ADL-IADL, mobility, falls, and quality of life. Smart homes show great potential in the management of chronic diseases by favouring the control of exacerbations and increasing patients’ safety by providing support in disease management, including support for cognitively impaired older people. The use of smart homes in the community could bring numerous benefits in terms of continuity of care, allowing the constant monitoring of older people by local and hospital health services.

The healthcare sector represents a major source of waste production, and healthcare workers (HCWs) are crucial in waste management. Educational interventions (EIs) can be delivered through a single component (mono-component) or by combining different components (multi-component); although they have a potential impact on the sustainability of healthcare, their effectiveness in waste management still needs to be identified. The aim of this systematic review and meta-analysis was to describe EIs to improve waste management knowledge, attitudes, and practices among HCWs and provide an estimate of their effectiveness. Six relevant databases were searched; 24 articles were included, and 19 were meta-analyzed. These were mainly from low-income countries and did not consider EIs for recycling, reducing, and reusing. Compared to the mono-component EIs, the multi-component Eis showed a higher statistically significant positive post-intervention effect on knowledge, with greater retention in the medium–long term, and on practices, particularly among non-hands-on HCWs. The effects of the EIs on attitudes were not significant. Our results suggest that multi-component EIs should be preferred to improve waste management standards in the healthcare sector. Given the heterogeneity found among EIs, the standardization of types, content, duration, and assessment methods should be considered. Finally, their harmonization at a global level could influence international and national policies on sustainability.

Objective To investigate the perception of self‐isolation at home in patients with cancer during the lockdown period resulting from the COVID‐19 outbreak in Italy. Methods A cross‐sectional descriptive study was conducted through an online survey of patients with cancer who were sheltering at home from 29th March to 3rd May 2020. Perception of self‐isolation was assessed using the ISOLA scale, after evaluation of its psychometric properties. Content analysis was used to analyse two open‐ended questions. Results The participants were 195 adult patients with cancer (female = 76%; mean age = 50.3 ± 11.2; haematological malignancy = 51.3%). They reported moderate isolation‐related suffering (M = 2.64 ± 0.81), problems in their relationships with others (M = 3.31 ± 1.13) and difficulties in their relationships with themselves (M = 3.14 ± 1.06). Patients who experienced significantly more social problems were older, had less education and were living without minor children. Overall, four main categories emerged from the qualitative content analysis: (1) lack of freedom and social life, (2) uncertainty and worries, (3) feeling supported and (4) dealing with isolation. Conclusion Living with cancer in the COVID‐19 pandemic was often perceived as an isolating experience, primarily in terms of detachment from loved ones.

Healthcare workers’ age is increasingly rising, negatively affecting their physical health. In particular, workability is an emerging phenomenon that predominantly affects healthcare workers. This study aims to assess physical health status and workability among ageing healthcare workers. A cross-sectional study using the Work Ability Index (WAI) was performed. Data were collected in a university hospital in northern Italy. Data were collected voluntary through a questionnaire. Healthcare workers participating in the survey were contacted personally by two resident physicians. Thus, the total number of study participants was 220 among nursing aides, nurses, and physicians. Data were analyzed by performing ANOVA and regression to assess the differences between the healthcare workers and age groups. A generalized linear model was tested to evaluate the effect of age and task on workability. The majority of healthcare workers had good WAI values. Physicians’ workability was higher than nursing aides. Nursing aides suffered more from cardiovascular disorders, while physicians and nurses had more musculoskeletal disorders. However, the distribution was statistically different (χ² = 24.03, p = 0.00), as most of the physicians’ workability values were good and good, while those of nursing aides and nurses were good and medium. In line with previous studies, the decrease in WAI with ageing is strictly dependent on the type of task assigned. Due to heavy physical tasks, nurses and nurses’ aides showed a greater WAI than physicians. This study highlights the critical issues faced by ageing healthcare professionals. In the near future, it is necessary to find solutions to cope with these changes and devise possible interventions aimed at ameliorating workability.

Background: Intensive care unit (ICU)–acquired weakness (ICUAW) is defined as a clinical syndrome of neuromuscular weakness, and a consequence of critical illness, unrelated to any other etiology. It is associated with difficult weaning from the ventilator, prolonged ICU stay, increased mortality, and other important long-term outcomes. Early mobilization is defined as any active exercise in which patients use their muscle strength actively or passively within the first 2 to 5 days of critical illness. Early mobilization can be safely initiated from the first day of admission to the ICU during mechanical ventilation. Objectives: The purpose of this review is to describe the effects of early mobilization on complications from ICUAW. Method: This was a literature review. Inclusion criteria were as follows: observational studies and randomized controlled trials conducted with adult patients (aged ≥18 years) admitted to the ICU were included. Studies selected were published in the last 11 years (2010-2021). Results: Ten articles were included. Early mobilization reduces muscle atrophy, ventilation, length of hospital stay, and ventilator-associated pneumonia and improves patients' responses to inflammation and hyperglycemia. Discussion: Early mobilization appears to have a significant impact on the prevention of ICUAW and appears to be safe and feasible. The results of this review could be useful for improving the provision of efficient and effective tailored care for ICU patients.

Aim: To explore family caregivers' experiences of contributing to self‐care of patients with chronic obstructive pulmonary disease (COPD).Design: A qualitative description study.Methods: Individual semi‐structured interviews were conducted face‐to face, by telephone or video calls in a purposive sample of 17 family caregivers of patients with COPD recruited in Italy, and analysed through content analysis. The consolidated criteria for reporting qualitative studies (COREQ) checklist was used for study reporting.Results: Ten subcategories were derived from 106 codes grouped into three main categories: family caregiver contributions to maintaining disease stable and ensuring a normal life for patients; family caregiver contributions to disease monitoring; and family caregiver contributions to coping with disease exacerbations. Family caregivers provided practical and emotional support, and their contribution was essential to improve treatment adherence, to enable the patient to continue living a normal life, and to have access to the healthcare services. Family caregivers were constantly vigilant and monitored patients daily to detect worsening conditions, and they managed exacerbations especially when patients were unable to do it due to their critical conditions.Conclusion: This study broadens knowledge of family caregivers' contributions to patients' self‐care in COPD, describing the different ways family members provide daily care to patients and the many responsibilities they take on.Impact: Family caregivers perform a variety of behaviours when supporting patients with COPD in self‐care, especially when patients are more dependent and the disease more severe. Nurses should acknowledge the various contributions provided by family caregivers and develop educational interventions aiming to support them in patient care and improve patient outcomes.Patient or Public Contribution: Researchers shared the draft study report with participants for validation and feedback. This helped to strengthen the study design and results.