Nursing student's knowledge about breastfeeding: Design and validation of the AprendeLact questionnaire

Background Breastfeeding is the best source of food that a mother can offer her child during the first months of life because it provides numerous benefits for both mother and baby. Despite breastfeeding being an innate act, it requires qualified health professionals for advice and support. Objectives and participants To design and validate a questionnaire to evaluate nursing student breastfeeding knowledge. Methods and design Cross-sectional study. Construction and validation of the questionnaire (content validity, test-retest reliability and internal consistency). Descriptive and bivariate analyses of socio-demographic variables and the questionnaire results. Results Optimum results were obtained in terms of internal consistency (KR-20 = 0.9) and test-retest reliability (ICC = 0.925) with a samples of 144 participants (mean age of 22.69 years). Statistical significance were observed among the questionnaire score and academic year, clinical practice, type of breastfeeding in childhood, knowing about support groups and participating in a breastfeeding workshop or course. Conclusion A questionnaire on breastfeeding knowledge was validated. Nursing students progressively acquire breastfeeding skills as they advance in their undergraduate studies

A genome-wide association study follow-up suggests a possible role for PPARG in systemic sclerosis susceptibility

Introduction: A recent genome-wide association study (GWAS) comprising a French cohort of systemic sclerosis (SSc) reported several non-HLA single-nucleotide polymorphisms (SNPs) showing a nominal association in the discovery phase. We aimed to identify previously overlooked susceptibility variants by using a follow-up strategy.<p></p> Methods: Sixty-six non-HLA SNPs showing a P value <10-4 in the discovery phase of the French SSc GWAS were analyzed in the first step of this study, performing a meta-analysis that combined data from the two published SSc GWASs. A total of 2,921 SSc patients and 6,963 healthy controls were included in this first phase. Two SNPs, PPARG rs310746 and CHRNA9 rs6832151, were selected for genotyping in the replication cohort (1,068 SSc patients and 6,762 healthy controls) based on the results of the first step. Genotyping was performed by using TaqMan SNP genotyping assays. Results: We observed nominal associations for both PPARG rs310746 (PMH = 1.90 × 10-6, OR, 1.28) and CHRNA9 rs6832151 (PMH = 4.30 × 10-6, OR, 1.17) genetic variants with SSc in the first step of our study. In the replication phase, we observed a trend of association for PPARG rs310746 (P value = 0.066; OR, 1.17). The combined overall Mantel-Haenszel meta-analysis of all the cohorts included in the present study revealed that PPARG rs310746 remained associated with SSc with a nominal non-genome-wide significant P value (PMH = 5.00 × 10-7; OR, 1.25). No evidence of association was observed for CHRNA9 rs6832151 either in the replication phase or in the overall pooled analysis.<p></p> Conclusion: Our results suggest a role of PPARG gene in the development of SSc

Cross-disease Meta-analysis of Genome-wide Association Studies for Systemic Sclerosis and Rheumatoid Arthritis Reveals IRF4 as a New Common Susceptibility Locus

Objectives: Systemic sclerosis (SSc) and rheumatoid arthritis (RA) are autoimmune diseases that share clinical and immunological characteristics. To date, several shared SSc- RA loci have been identified independently. In this study, we aimed to systematically search for new common SSc-RA loci through an inter-disease meta-GWAS strategy. Methods: We performed a meta-analysis combining GWAS datasets of SSc and RA using a strategy that allowed identification of loci with both same-direction and opposingdirection allelic effects. The top single-nucleotide polymorphisms (SNPs) were followed-up in independent SSc and RA case-control cohorts. This allowed us to increase the sample size to a total of 8,830 SSc patients, 16,870 RA patients and 43,393 controls. Results: The cross-disease meta-analysis of the GWAS datasets identified several loci with nominal association signals (P-value < 5 x 10-6), which also showed evidence of association in the disease-specific GWAS scan. These loci included several genomic regions not previously reported as shared loci, besides risk factors associated with both diseases in previous studies. The follow-up of the putatively new SSc-RA loci identified IRF4 as a shared risk factor for these two diseases (Pcombined = 3.29 x 10-12). In addition, the analysis of the biological relevance of the known SSc-RA shared loci pointed to the type I interferon and the interleukin 12 signaling pathways as the main common etiopathogenic factors. Conclusions: Our study has identified a novel shared locus, IRF4, for SSc and RA and highlighted the usefulness of cross-disease GWAS meta-analysis in the identification of common risk loci

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Conocimientos sobre lactancia materna de los estudiantes del grado de enfermería de la Universitat Jaume I

Treball Final de Grau en Infermeria. Codi: IN1138. Curs acadèmic: 2016/2017Introducción: Según la Organización Mundial de la Salud (OMS), la lactancia materna (LM) debe ser exclusiva hasta los seis meses de edad, introduciendo alimentos complementarios sin abandonarla hasta los dos años o más. En España solo el 28,5% de los niños lacta a los seis meses. La LM es un factor promotor de la salud, donde el personal sanitario tiene un papel fundamental. Por tanto, como objetivo de este estudio se plantea el diseño y validación de un cuestionario para conocer los conocimientos sobre LM en estudiantes de enfermería. Metodología: Se realizó un estudio observacional, transversal y descriptivo. En la primera fase se llevo a cabo, la construcción y validación del cuestionario, incluyendo la validez de contenido, el estudio de la fiabilidad test-retest y la consistencia interna. En la segunda fase, se realizó un análisis descriptivo y bivariante de los resultados obtenidos en el cuestionario y las variables sociodemográficas. Resultados: Se modifico el cuestionario tras el grupo nominal. Se obtuvieron resultados satisfactorios en cuanto a consistencia interna (KR-20=0.9) y fiabilidad test-retest (CCI=0.925). Se conto con 144 participantes con una edad media de 22.69 años. Se observo significación estadística entre la puntuación del cuestionario y el curso académico, las practicas clínicas, el tipo de lactancia en la infancia, conocer grupos de apoyo y participar en un taller o curso de LM. Conclusión: Se ha validado un cuestionario sobre conocimientos en LM. Los estudiantes de enfermería presentan una adquisición progresiva de competencias sobre LM a medida que avanzan los estudios de grado.Introduction: According to the World Health Organization (WHO), babies should be breastfeed during the first six months and complementary food must be gradually introduced without left breastfeed until 2 years or more. In Spain only the 28,5% of the children still breastfeeding at the sixth month. Breastfeeding is a pro-health factor, whereas health personnel play a key role. Therefore, the design and validation of a questionnaire is planned as a main goal in the present study in order to become acquainted of the general kwonledge about breastfeeding in Nursing Degree students Methodology: A cross-sectional observational and descriptive study was conducted. In the first phase, the elaboration and validation of the questionnaire including the content validity, the reliability of the test-retest and the internal consistency was accomplished. In the second phase, a descriptive and bivariate analysis of the results of the questionnaire was conducted, as well as the socio-demographical variables. Results: Following the nominal group technique, the questionnaire was modified. Satisfactory results were obtained in terms of internal consistency (KR=0,9) and reliability test-retest (CIC=0,925). A total of 144 people had participated with an average age of 22,69. Statistical significance was oberved between the questionnaire score and the academic year, the clinical practices, the type of breastfeeding, knowing support groups and also the participation in a seminar or course of breastfeeding. Conclusion: A questionnaire concerning knowledge on breastfeeding has been validated. Nursing Degree students show a gradual acquisition on breastfeeding competence as the degree progresses

Multiscale porosity in mesoporous bioglass 3D-printed scaffolds for bone regeneration.

In order to increase the bone forming ability of MBG-PCL composite scaffold, microporosity was created in the struts of 3D-printed MBG-PCL scaffolds for the manufacturing of a construct with a multiscale porosity consisting of meso- micro- and macropores. 3D-printing imparted macroporosity while the microporosity was created by porogen removal from the struts, and the MBG particles were responsible for the mesoporosity. The scaffolds were 3D-printed using a mixture of PCL, MBG and phosphate buffered saline (PBS) particles, subsequently leached out. Microporous-PCL (pPCL) as a negative control, microporous MBG-PCL (pMBG-PCL) and non- microporous-MBG-PCL (MBG-PCL) were investigated. Scanning electron microscopy, mercury intrusion poros-imetry and micro-computed tomography demonstrated that the PBS removal resulted in the formation of mi-cropores inside the struts with porosity of around 30% for both pPCL and pMBG-PCL, with both constructs displaying an overall porosity of 8090%. In contrast, the MBG-PCL group had a microporosity of 6% and an overall porosity of 70%. Early mineralisation was found in the pMBG-PCL post-leaching out and this resulted in the formation a more homogeneous calcium phosphate layer when using a biomimetic mineralisation assay. Mechanical properties ranged from 5 to 25 MPa for microporous and non-microporous specimens, hence microporosity was the determining factor affecting compressive properties. MC3T3-E1 metabolic activity was increased in the pMBG-PCL along with an increased production of RUNX2. Therefore, the microporosity within a 3D-printed bioceramic composite construct may result in additional physical and biological benefits

Burnout syndrome in nursing students: An observational study

Background: Academic burnout appears attributable to work and academic overload and may negatively affect learning and care quality during clinical clerkship. Objectives: To evaluate the presence of burnout syndrome in nursing students and to detect the main stressors that occur during clinical clerkship. Design: Observational, descriptive and cross-sectional study carried out between January and July 2017. Settings and participants: Second-, third- and fourth-year nursing students at Jaume I University (Universitat Jaume I) (Spain) (n = 126). Methods: The KEZKAK questionnaire and the Maslach Burnout Inventory Student Survey were used when carrying out the data collection; sociodemographic and clinical clerkship variables were also collected. Descriptive and bivariate analyses of these instruments' variables were performed. Results: No student manifested high levels of depersonalisation or low personal accomplishment. Moreover, depersonalisation was found to increase as the academic year progressed (p = 0.027). The most stressful factors were Helplessness and Uncertainty (m = 3.61, sd = 0.345) and Confusion of Medication (m = 2.50, sd = 0.754). The female subsample showed higher stress levels due to multiple factors, such as Lack of Competence (p = 0.001) and Having to Give Bad News (p = 0.01). Conclusion: This study found that its sample did not meet the criteria indicating the presence of burnout syndrome. In addition, the main stressors affecting nursing students during clinical clerkship were identified

Fomentando la educación para la sostenibilidad en la formación de maestros a través de espacios verdes -Huerto Didáctico y Real Jardín Botánico- como recursos educativos

El presente documento es la memoria del proyecto de innovación docente "Fomentando la educación para la sostenibilidad en la formación de maestros a través de espacios verdes -Huerto Didáctico y Real Jardín Botánico- como recursos educativos". En dicha memoria se especifican los objetivos propuestos, esto es que los/as alumnos/as adquieran conocimientos vinculados con la biología y la ecología, así como competencias transversales como el pensamiento reflexivo y valores democráticos y de sostenibilidad trabajando en espacios verdes. Se reportan las actividades realizadas en el Huerto Didáctico de la Facultad de Educación-CFP de la UCM y en el Real Jardín Botánico Alfonso XIII para la consecución de esos objetivos, concluyendo que los alumnos son capaces de aprender sobre la materia y ejecutar tareas de cuidado hortícola, a la vez que conectar con el medio natural cuando llevan a cabo actividades en los espacios verdes de la UCM