Hospital volunteering experiences suggest that new policies are needed to promote their integration in daily care: Findings from a qualitative study

Objective: To explore Hospital Volunteers\u2019 (HVs) motivations and experiences, as well as the strategies they adopt to overcome challenging situations during volunteering and the needs they perceive. Methods: Eleven Italian HVs were purposively approached between January and July 2016, using face-to-face semi-structured interviews. The interviews were audio-recorded, transcribed verbatim and analysed using the descriptive phenomenological approach. Results: Hospital volunteering emerged as a complex experience characterised by five themes: (a) becoming a volunteer; (b) developing skills; (c) experiencing conflicting emotions; (d) overcoming role difficulties by enacting different resources and strategies; and (e) addressing emerging needs. Conclusions: According to the findings, hospital policies aimed at promoting volunteer integration in daily care are needed and should be based on (a) a shared vision between the hospital and the volunteer associations regarding the HVs\u2019 role and skills; (b) the development of integrated models of care combining different workforces (i.e. professionals and volunteer staff); (c) appropriate training of HVs at baseline; (d) individualised continuous education pathways aimed at supporting HVs both emotionally and in the development of the required skills; and (e) tailored education that is directed to health-care staff aimed at helping them to value the service provided by HVs

Antidepressants and Suicide Risk: A Comprehensive Overview

The annual worldwide suicide rate currently averages approximately 13 per 100,000 individuals per year (0.013% per year), with higher average rates for men than for women in all but a few countries, very low rates in children, and relatively high rates in elderly men. Suicide rates vary markedly between countries, reflecting in part differences in case-identification and reporting procedures. Rates of attempted suicide in the general population average 20–30 times higher than rates of completed suicide, but are probably under-reported. Research on the relationship between pharmacotherapy and suicidal behavior was rare until a decade ago. Most ecological studies and large clinical studies have found that a general reduction in suicide rates is significantly correlated with higher rates of prescribing modern antidepressants. However, ecological, cohort and case-control studies and data from brief, randomized, controlled trials in patients with acute affective disorders have found increases, particularly in young patients and particularly for the risk of suicide attempts, as well as increases in suicidal ideation in young patients. whether antidepressants are associated with specific aspects of suicidality (e.g., higher rates of completed suicide, attempted suicide and suicidal ideation) in younger patients with major affective disorders remains a highly controversial question. In light of this gap this paper analyzes research on the relationship between suicidality and antidepressant treatment

[The quality of life as perceived by older people. Results of a phenomenological study]

Elderly Quality of life (QoL) is vulnerable because of the decline in physical and mental capacity, discharge from work, rupture of the family and isolation. Many QoL Scales are made for adults: there is little research investigating how older people perceive QOL

Visible and invisible caring in nursing from the perspectives of patients and nurses in the gerontological context

Scand J Caring Sci. 2013 Dec 4. doi: 10.1111/scs.12105. [Epub ahead of print] Visible and invisible caring in nursing from the perspectives of patients and nurses in the gerontological context. Canzan F1, Heilemann MV, Saiani L, Mortari L, Ambrosi E. Author information Abstract AIM: Just as in many countries all over the world, the number of older people in Italy has increased rapidly. Consequently, an increasing number of nurses are engaged in the care of older patients. However, due to a lack of understanding of how nurses and patients perceive caring, nursing care may be compromised. The aim of this study is to explore, describe and compare the perceptions of gerontological nurses and patients related to the dimensions of caring in nursing in an Italian hospital setting. METHODS: In this qualitative descriptive study, a variety of analytic techniques were used to analyse semi-structured interview data from a purposeful sample of 20 nurses and 20 patients from geriatric units in two different Italian hospitals. FINDINGS: Although both nurses and patients gave rich descriptions of caring experiences, patients described features of caring in nursing that were visible (including nurses' caring gestures, giving attention and being competent) while nurses predominantly emphasised aspects of caring that were relatively invisible (such as reflecting on the patient's past needs, evaluating the nursing care rendered, planning for more appropriate future nursing care, taking multiple complex contextual factors into account to protect the patient and being competent). CONCLUSION: Our data revealed more nuanced insight into the meaning of invisible and visible caring in nursing within the gerontological context than has been previously reported in the literature. This has implications for nursing education and practice because it may help nurses meet the actual needs of older patients in hospital settings

Cutting edge: IgE plays an active role in tumor immunosurveillance in mice

Exogenous IgE acts as an adjuvant in tumor vaccination in mice, and therefore a direct role of endogenous IgE in tumor immunosurveillance was investigated. By using genetically engineered mice, we found that IgE ablation rendered mice more susceptible to the growth of transplantable tumors. Conversely, a strengthened IgE response provided mice with partial or complete resistance to tumor growth, depending on the tumor type. By genetic crosses, we showed that IgE-mediated tumor protection was mostly lost in mice lacking FceRI. Tumor protection was also lost after depletion of CD8+ T cells, highlighting a cross-Talk between IgE and T cell- mediated tumor immunosurveillance. Our findings provide the rationale for clinical observations that relate atopy with a lower risk for developing cancer and open new avenues for the design of immunotherapeutics relevant for clinical oncology. The Journal of Immunology, 2016, 197: 2583-2588

Il caring nella pratica: una teoria descrittiva

Per parlare del nursing come caring e, nello specifico, per sostenere la tesi secondo la quale un buon nursing \ue8 tutt\u2019uno con il caring, \ue8 necessario sviluppare un processo argomentativo capace di mostrare come il caring sia un\u2019attivit\ue0 complessa, multidimensionale che richiede \u201cpensiero, sentimento e azione competente\u201d. Il caring esprime azioni eticamente significative con le quali gli infermieri si occupano e si preoccupano dei pazienti. Se la scienza del nursing \ue8 la scienza del caring, diventa questione rilevante e significativa per la ricerca approfondire il tema della cura per cogliere l\u2019essenza di una buona pratica di cura infermieristica. Questo testo si propone un percorso sia di ricerca teoretica sia empirica sul caring infermieristico. La domanda di ricerca che ha guidato tutto il processo d\u2019indagine qui documentato \ue8: in che cosa consiste un buon caring infermieristico? Il gruppo di ricerca \ue8 costituito da due ricercatrici accademiche e sei infermiere interessate ad apprendere il lavoro di ricerca nella pratica. La scelta di un gruppo misto \ue8 motivata dal fatto che indagare sulla cultura dei pratici senza la loro mediazione non avvicina all\u2019essenza. La ricerca di matrice fenomenologica ha chiesto ai pratici di dar voce al loro pensiero sull\u2019attivit\ue0 di caring, di interpellare la loro esperienza attraverso la narrazione; sulle loro parole piene di realt\ue0 i ricercatori hanno ricostruito il significato e una concettualizzazione del caring infermieristico

Downregulation of G protein-coupled receptor kinase 2 levels enhances cardiac insulin sensitivity and switches on cardioprotective gene expression patterns

G protein-coupled receptor kinase 2 (GRK2) has recently emerged as a negative modulator of insulin signalling. GRK2 downregulation improves insulin sensitivity and prevents systemic insulin resistance (IR). Cardiac GRK2 levels are increased in 5 human heart failure, while genetically inhibiting GRK2 leads to cardioprotection in mice. However, the molecular basis underlying the 6 deleterious effects of GRK2 up-regulation and the beneficial effects of its inhibition in the heart are not fully understood. Therefore, 7 we have explored the interconnections among a systemic IR status, GRK2 dosage and cardiac insulin sensitivity in adult (9 month-old) animals. GRK2+/- mice display enhanced cardiac insulin sensitivity and mild heart hypertrophy with preserved systolic function. Cardiac gene expression is reprogrammed in these animals, with increased expression of genes related to physiological hypertrophy, while the expression of genes related to pathological hypertrophy or to diabetes/obesity co-morbidities is repressed. Notably, we find that cardiac GRK2 levels increase in situations where IR develops, such as in ob/ob mice or after high fat diet feeding. Our data suggest that GRK2 downregulation/inhibition can help maintain cardiac function in the face of co-morbidities such as IR, diabetes or obesity by sustaining insulin sensitivity and promoting a gene expression reprogramming that confers cardioprotection.Grants from Ministerio de Educación y Ciencia (SAF2011-23800), Fundación para la Investigación Médica Aplicada (FIMA) and UTE project CIMA, The Cardiovascular Network of Ministerio Sanidad y Consumo-Instituto Carlos III (RD06-0014/0037 and RD12/0042/0012), Comunidad de Madrid (S2010/BMD-2332) and EFSD-Novo Nordisk to F.M and UAM Grupo Santander to C.M and Wood-Whelan Research Fellowship from IUBMB to E.L. We also acknowledge institutional support from Fundación Ramón Arece

Neuronal models of TDP-43 proteinopathy display reduced axonal translation, increased oxidative stress, and defective exocytosis

Amyotrophic lateral sclerosis (ALS) is a progressive, lethal neurodegenerative disease mostly affecting people around 50–60 years of age. TDP-43, an RNA-binding protein involved in pre-mRNA splicing and controlling mRNA stability and translation, forms neuronal cytoplasmic inclusions in an overwhelming majority of ALS patients, a phenomenon referred to as TDP-43 proteinopathy. These cytoplasmic aggregates disrupt mRNA transport and localization. The axon, like dendrites, is a site of mRNA translation, permitting the local synthesis of selected proteins. This is especially relevant in upper and lower motor neurons, whose axon spans long distances, likely accentuating their susceptibility to ALS-related noxae. In this work we have generated and characterized two cellular models, consisting of virtually pure populations of primary mouse cortical neurons expressing a human TDP-43 fusion protein, wt or carrying an ALS mutation. Both forms facilitate cytoplasmic aggregate formation, unlike the corresponding native proteins, giving rise to bona fide primary culture models of TDP-43 proteinopathy. Neurons expressing TDP-43 fusion proteins exhibit a global impairment in axonal protein synthesis, an increase in oxidative stress, and defects in presynaptic function and electrical activity. These changes correlate with deregulation of axonal levels of polysome-engaged mRNAs playing relevant roles in the same processes. Our data support the emerging notion that deregulation of mRNA metabolism and of axonal mRNA transport may trigger the dying-back neuropathy that initiates motor neuron degeneration in ALS