Politiche professionali: studio qualitativo sulle percezioni e le opinioni dei professionisti infermieri/ostetriche e degli studenti della Laurea magistrale in Scienze infermieristiche e ostetriche.

Introduzione. La politica, ovvero la scienza e l'arte di amministrare la cosa pubblica, è un ambito di grande importanza e occuparsi di politica professionale significa dedicarsi al bene della professione. Le politiche professionali sono parte integrante del prendersi cura e la famiglia professionale ha bisogno di punti chiari di riferimento: formazione, tutela, promozione, rappresentanza istituzionale.Obiettivo. Esplorare percezioni, idealití , immaginario condiviso e desideri circa le politiche professionali di infermieri/ostetriche e studenti della laurea magistrale per riuscire ad avere una rappresentazione della realtí  e avviare una riflessione critica sul tema. Metodo. È stato effettuato uno studio qualitativo su un campione propositivo di 22 professionisti infermieri/ostetriche quali testimoni qualificati della situazione nazionale. I dati sono stati raccolti attraverso un questionario costruito ad hoc.Risultati. Dall'analisi delle risposte sono emersi 10 temi principali, tra i quali spiccano: per la formazione l'importanza delle nuove conoscenze ma anche la scarsa differenziazione dei ruoli; per l'ambito lavorativo l'assenza di meritocrazia e di nuove opportunití ; per la ricerca il divario tra teoria e pratica. In sintesi, i risultati evidenziano come la partecipazione ai processi di formazione delle politiche sia saltuaria e di poca intensití  e come pochi infermieri/ostetriche siano coinvolti attivamente per la promozione e sviluppo di progetti nel settore delle politiche per i sistemi sanitari e per la salute.Conclusioni. L'indagine rileva che vi è una coscienza forte delle problematicití  esistenti, ma questa coscienza non sembra relazionarsi adeguatamente ai contesti lavorativi, istituzionali e culturali. Di conseguenza non si verifica quella necessaria crescita delle politiche professionali, la sola capace di generare percorsi politici atti a risolvere le questioni di fondo. Parole chiave: politica sanitaria, partecipazione politica, infermieri/ostetriche, leadership politica.Professional policies: a qualitative study of perceptions and opinions of professionals nurses/midwives and students attending the Master of Science in NursingABSTRACTIntroduction. Politics, the science and the art of administering public affairs, is a very important field. Dealing with professional policy means to dedicate ourselves to the good of the profession. Professional policies are an integral part of taking care; the professional family needs clear reference points: training, tutoring, promotion and institutional representation.Aim. Exploring perceptions, ideals, shared imagination and desires about the professional policies of nurses/midwives and of master's students in order to be able to have a representation of the reality and to start a critical reflection on the subject. Method. A qualitative study was conducted on a proactive sample of 22 nurses / midwives as qualified witnesses of the national situation. The data was collected through a questionnaire built ad hoc.Results.  From the analysis of the answers given to the questionnaire, we identified 10 main themes. In the training sector two of the themes that were selected are the importance of the new knowledges and inadequate differentiation of the positions; Regarding the working sector two of the themes that came out are the lack of meritocracy and of new opportunities; meanwhile, in the research field one of the main theme identified is the gap between the theory and the practice.Conclusions.  The present study finds out that participation in policy-making processes is occasional and of little intensity: just few nurses/midwives are actively involved in the promotion and development of projects in the health sector and of healthcare policies. Keywords: health policy, political participation, nurses/midwiferies, political leadership

The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study.

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age- and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to ~2.8M SNPs with BMI and WHRadjBMI in four strata (men ≤50y, men >50y, women ≤50y, women >50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR<5%) age-specific effects, of which 11 had larger effects in younger (<50y) than in older adults (≥50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may provide further insights into the biology that underlies weight change with age or the sexually dimorphism of body shape

Correction: The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study

[This corrects the article DOI: 10.1371/journal.pgen.1005378.].status: publishe

Age-dependent BMI loci.

<p>Effect estimates (beta ±95CI) per standard deviation in BMI and risk allele for loci showing age-differences in men & women ≤50y compared to men & women >50y. Loci are ordered by greater magnitude of effect in men & women ≤50y compared to men & women >50y. (95%CI: 95% confidence interval; BMI: body mass index; SD: standard deviation, *Newly identified loci).</p

Fifteen BMI loci showing significant age-differences in adults ≤50y compared to adults >50y.

<p>Chr: Chromosome; Pos: position; EAF: Effect Allele Frequency; EA: Effect allele; OA: Other allele</p><p>^a ‘Yes’ if the locus is mentioned as BMI locus for the first time</p><p>^b Effect allele is according to the BMI increasing allele according to the associated sex.</p><p>The table shows the age-group specific (sex-combined) results, ordered by largest to smallest effect in adults ≤50y. All loci were detected by the screen on age-difference that included the a-priori filter on <i>P</i>_{<i>Overall</i>} < 10⁻⁵. The age- and sex-specific results (four strata) and more detailed information on the loci are given in <b><a href="http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1005378#pgen.1005378.s020" target="_blank">S4 Table</a></b>.</p

Forty-four WHR_adjBMI loci showing significant sex-differences.

<p>Chr: Chromosome; Pos: position; EAF: Effect Allele Frequency; EA: Effect allele; OA: Other allele</p><p>^a ‘Yes’ if the locus is mentioned as WHR_adjBMI locus for the first time</p><p>^b ‘Yes’ if the sex-difference in the effect on WHR_adjBMI is reported for the first time</p><p>^c Effect allele is according to the WHR_adjBMI increasing allele according to the associated sex.</p><p>The table shows the sex-specific (age-group combined) results, ordered by largest, positive effect in women to largest, negative effect in women. The age- and sex-specific results (four strata), more detailed information on the loci and on the screens for which they were detected are given in <b><a href="http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1005378#pgen.1005378.s021" target="_blank">S5 Table</a></b>.</p

Power heatplots.

<p>Power for the combination of screens and gain through a priori filtering for varying configurations of effect sizes across the 4 strata. The figures illustrate (A) the power to detect age-difference, sex-difference or age-sex-difference in at least one of our scans (on <i>P</i>_{<i>agediff</i>}, <i>P</i>_{<i>sexdiff</i>} and <i>P</i>_{<i>agesexdiff</i>}, with and without a priori filtering); and (B) a power comparison, comparing approaches with and without a priori filtering on <i>P</i>_{<i>Overall</i>} < 1x10^-5. We here assume four equally sized strata and a total sample size of N = 300,000 (comparable to the sample size in our BMI analyses). We set b_F≤50y = 0.033 (corresponding to a known and mean BMI effect in <i>MAP2K5</i> region with R² = 0.037%), b_M>50y = 0, and vary b_F>50y and b_M≤50 on the axes. This strategy allows us to cover the most interesting and plausible interaction effects: Two-way interactions, such as (i) pure age-difference (b_≤50y = 0.033, b_>50y = 0) and (ii) pure sex-difference (b_F = 0.033, b_M = 0); and three-way interactions, such as (iii) extreme three-way interaction with opposite direction across AGE and SEX, (iv) 1-strata interaction (b_F≤50y = 0.033, b_F>50y = b_M≤50y = b_M>50y = 0), and (v) 3-strata interaction (b_F≤50y = b_F>50y = b_M≤50y = 0.033, b_M>50y = 0).</p

Sex-dependent WHR_adjBMI loci.

<p>Effect estimates (beta ± 95CI) per standard deviation in WHR_adjBMI and risk allele for loci showing sex-differences in women compared to men. Loci are ordered by greater magnitude of effect in women compared to men. (95%CI: 95% confidence interval; SD: standard deviation. *Newly identified loci. † Newly identified sex-differences)</p