The undergraduate nursing student evaluation of clinical learning environment: an Italian survey [La valutazione dell'ambiente di apprendimento clinico da parte degli studenti del Corso di Laurea in Infermieristica: una indagine italiana]

BACKGROUND: Nursing students have to deal with many different clinical and practical aspects of knowledge to become skilled professionals. Student perception may be considered an indicator of teaching quality, since positive perception of students is strictly related to their effective professional learning. The Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale is considered the gold standard psychometric instrument to evaluate both the quality and the climate of clinical learning environment. AIMS: To evaluate the quality of nurse teaching by means of CLES+T scale and to highlight significant correlations between CLES+T scale and selected characteristics of both students and clinical environments. METHODS: On 4 March 2013, a cross-sectional survey was conducted at University of Modena: CLES+T scale was administered during a plenary convocation to 242 nursing students who attended the second and third years of Nursing Degree. All 34 items of the scale were statistically analysed using the median test. RESULTS: The median values were uniformly represented by "4" level (on the Likert scale). The final marks of clinical learning experience were the only variable statistically significantly related to the scale scores. The paediatrics and emergency areas obtained the highest scale scores. CONCLUSIONS: The nursing student evaluations were uniformly positive and related to their positive final marks. A positive ward atmosphere was identified as especially important in this study. These data indicate that a non-hostile and hospitable environment can favour the best clinical learning. We conclude that CLES+T scale can be a useful instrument to explore the clinical climate in all hospital areas and to highlight critical clinical situations

Panhypopituitarism, a Cause of Early Sudden Infant Death Syndrome?

Panhypopituitarism can manifest itself with variable signs and symptoms, and in some cases it may be responsible for serious events such as cardio-respiratory insufficiency and hypoglycemia which can be fatal. It can be assumed that a condition of panhypopituitarism can cause early sudden death that occurs in the first hours of life. For this reason it is important that the post mortem examination in SIDS (Sudden Infant Death Syndrome) patients includes the study of the pituitary gland. We present a newborn with panhypopituitarism, in which the onset was dramatic, with severe cardio-respiratory insufficiency and severe hypoglycemia and only the accidentally detection by midwives was life saving. Array CGH analysis showed a microdeletion of chromosome 5q34, including part of the intronic region of the gene ODZ2 inherited from the mother, not related to the patient's symptoms so far

The undergraduate nursing student evaluation of clinical learning environment: an Italian survey

AbstractBackground: Nursing students have to deal with many different clinical and practical aspects of knowledge to become skilled professionals. Student perception may be considered an indicator of teaching quality, since positive perception of students is strictly related to their effective professional learning. The Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale is considered the gold standard psychometric instrument to evaluate both the quality and the climate of clinical learning environment. Aims: To evaluate the quality of nurse teaching by means of CLES+T scale and to highlight significant correlations between CLES+T scale and selected characteristics of both students and clinical environments. Methods: On 4 March 2013, a cross-sectional survey was conducted at University of Modena: CLES+T scale was administered during a plenary convocation to 242 nursing students who attended the second and third years of Nursing Degree. All 34 items of the scale were statistically analysed using the median test. Results: The median values were uniformly represented by "4" level (on the Likert scale). The final marks of clinical learning experience were the only variable statistically significantly related to the scale scores (p<0.01). The paediatrics and emergency areas obtained the highest scale scores. Conclusions: The nursing student evaluations were uniformly positive and related to their positive final marks. A positive ward atmosphere was identified as especially important in this study. These data indicate that a non-hostile and hospitable environment can favour the best clinical learning. We conclude that CLES+T scale can be a useful instrument to explore the clinical climate in all hospital areas and to highlight critical clinical situations. Key-words: clinical learning environment, nursing student, CLES+T scale RiassuntoIntroduzione: Per divenire dei professionisti qualificati, gli studenti infermieri sperimentano diverse esperienze di tirocinio clinico. L'opinione dello studente può essere considerata un indicatore della qualití  dell'insegnamento e una percezione positiva dell'esperienza di tirocinio si correla strettamente ad un apprendimento efficace. La scala CLES+T (Clinical Learning Environment and Supervision plus Nurse Teacher) è lo strumento psicometrico "gold standard" per valutare la qualití  dell'ambiente di apprendimento clinico. Scopo: Valutare la qualití  dell'ambiente di apprendimento clinico mediante la scala (CLES+T) ed evidenziare significative correlazioni inerenti le caratteristiche degli studenti, del modello tutoriale e dell'ambiente clinico. Metodo: Il 4 marzo 2013, durante una convocazione plenaria, è stata somministrata la scala CLES+T ai 242 studenti del 2° e 3° anno del Corso di Laurea in Infermieristica di Modena (Universití  di Modena e Reggio Emilia). Tutti i risultati sono stati statisticamente analizzati (Test della mediana). Risultati: Tutti i valori mediani si sono attestati ad un livello "4" (scala di Likert). La valutazione ottenuta dallo studente al termine del tirocinio clinico è l'unica variabile statisticamente correlata ai punteggi della scala (p<0.01), più il voto è basso peggiore risulta la valutazione dell'esperienza di tirocinio. In base all'opinione degli studenti le aree cliniche pediatriche e critiche hanno valutazioni più elevate. Conclusioni: Le valutazioni degli studenti erano uniformemente positive ed erano correlate al voto finale di tirocinio. Un clima di apprendimento positivo è stato considerato molto importante in questo studio. Questi risultati suggeriscono che un ambiente di apprendimento clinico favorevole e non ostile può influenzare gli esiti dell'apprendimento degli studenti. Concludiamo affermando che la scala CLES+T può essere uno strumento utile per esplorare il clima in tutte le aree ospedaliere e consentire di mettere in evidenza situazioni critiche.Parole Chiave: ambiente di apprendimento clinico, studente infermiere, scala CLES+

Prevalence of hypospadias in Italy according to severity, gestational age and birthweight: an epidemiological study

<p>Abstract</p> <p>Background</p> <p>Hypospadias is a congenital displacement of the urethral meatus in male newborns, being either an isolated defect at birth or a sign of sexual development disorders. The aim of this study was to assess the prevalence rate of hypospadias in different Districts of Italy, in order to make a comparison with other countries all over the world.</p> <p>Methods</p> <p>We reviewed all the newborns file records (years 2001–2004) in 15 Italian Hospitals.</p> <p>Results</p> <p>We found an overall hypospadias prevalence rate of 3.066 ± 0.99 per 1000 live births (82.48% mild hypospadias, 17.52% moderate-severe). In newborns Small for Gestational Age (birthweight < 10^thpercentile) of any gestational age the prevalence rate of hypospadias was 6.25 per 1000 live births. Performing multivariate logistic regression analysis for different degrees of hypospadias according to severity, being born SGA remained the only risk factor for moderate-severe hypospadias (p = 0.00898) but not for mild forms (p > 0.1).</p> <p>Conclusion</p> <p>In our sample the prevalence of hypospadias results as high as reported in previous European and American studies (3–4 per 1000 live births). Pathogenesis of isolated hypospadias is multifactorial (genetic, endocrine and environmental factors): however, the prevalence rate of hypospadias is higher in infants born small for gestational age than in newborns with normal birth weight.</p

Mechanisms of action and antiproliferative properties of Brassica oleracea juice in human breast cancer cell lines

none7noCruciferous vegetables are an important source of compounds that may be useful for chemoprevention. In this study, we evaluated the antiproliferative activity of juice obtained from leaves of several varieties of Brassica oleracea on both estrogen receptor (ER)-positive (ER; MCF-7 and BT474) and ER-negative (ER; MDA-MB-231 and BT20) human breast cancer cell lines. The effect of juice on cell proliferation was evaluated on DNA synthesis and on cell cycle–related proteins. Juice markedly reduced DNA synthesis, evaluated by [3H]thymidine incorporation, starting from low concentrations (final concentration 5–15 mL/L), and this activity was independent of ER. All cauliflower varieties tested suppressed cell proliferation in a dose-dependent manner. Cell growth inhibition was accompanied by significant cell death at the higher juice concentrations, although no evidence of apoptosis was found. Interestingly, the juice displayed a preferential activity against breast cancer cells compared with other mammalian cell lines investigated (ECV304, VERO, Hep2, 3T3, and MCF-10A) (P 0.01). At the molecular level, the inhibition of proliferation was associated with significantly reduced CDK6 expression and an increased level of p27 in ER cells but not in ER cells, whereas a common feature in all cell lines was significantly decreased retinoblastoma protein phosphorylation. These results suggest that the edible part of Brassica oleracea contains substances that can markedly inhibit the growth of both ER and ER human breast cancer cells, although through different mechanisms. These results suggest that the widely available cruciferous vegetables are potential chemopreventive agents. JopenBrandi, Giorgio; Schiavano, GIUDITTA FIORELLA; Zaffaroni, N; De Marco, C; Paiardini, M; Cervasi, B; Magnani, MauroBrandi, G; Schiavano, Gf; Zaffaroni, N; De Marco, C; Paiardini, M; Cervasi, B; Magnani, M

La\ua0Petraia\ua0(Firenze) UNESCO World Heritage

This chapter focuses on Villa Medici La Petraia (UNESCO World Heritage), built in the XV century in Florence, Italy. The relevance of this study case is due to a specific intervention that, during the XIX century, heavily influenced indoor microclimate: the addition of a glass and cast iron cover on the central courtyard. The change of status of this space, from outdoor to indoor, had an important effect on the whole microclimate of the Villa, as well as several other interventions including the addition of stoves and other systems of central heating. Finally, in the XX century, the Villa become a museum and no HVAC system has been added since then. On this specific case was carried on an extensive and complete analysis, including: archival research for historic documents; survey of the building and of the HVAC systems; monitoring of indoor microclimate in three different spaces, including the covered courtyard; software modeling and calibration of the model; construction past configurations, with and without covering in the courtyard, and analysis of the associated microclimate; up to the suggestion of management solutions for microclimatic issues. Where the study case of the Malatestiana Library, presented in Chapter 8, has been the beginning of the research on HIM, the case of Villa La Petraia represents a fully developed analysis of indoor microclimate, giving some sort of standard on how to perform these kind of studies and increasing the knowledge on HIM in general and on simulations and the prediction of future microclimatic conditions in particular