Symptom-Level Description of Nursing Perceptions About Unwarranted Clinical Variation, Inequality in Access to Cancer Services, Specific-Symptom Knowledge: An Italian Web-Based Survey

Objectives: This study aimed to describe the cancer nurses’ views regarding the relevance of cancer symptom-specific knowledge, unwarranted clinical variation, and inequities in access to cancer services. Describing how nurses perceive these aspects could help identify research priorities and a practical framework to prioritize clinical practice guidelines. Data Sources: A web-based survey was performed using a convenience sample of 810 nurses employed in cancer settings and cross-sectional data collection. The survey adopted a previously validated questionnaire investigating 14 symptoms. Conclusion: This study revealed which cancer symptoms require priority attention to define evidence-grounded guidance for decreasing unwarranted clinical variation and inequities in access to cancer services. Future multiprofessional and multinational studies are recommended to provide an in-depth description of the investigated phenomena. Implications for Nursing Practice: Participants reported higher mean scores in pain-specific knowledge than other symptoms. Social functioning alterations and psychological disorders seem to be highly susceptible to unwarranted clinical variation and inequities in access to cancer services. This information could drive tailored interventions to improve nursing practice

The Role of Professional Competency in Influencing Job Satisfaction and Organizational Citizenship Behaviour among Palliative Care Nurses

It is crucial that palliative care nurses feel competent to practice their profession in accordance with ethical principles, to personalise care, to remain sensitive, to ensure respect, and to communicate effectively. The aim of this study was to verify that higher levels of perceived professional competency predict better individual and organizational outcomes, such as job satisfaction (JS) and organizational citizenship behaviour (OCB). METHOD: An online cross-sectional survey was conducted with 107 Italian palliative care nurses. Structural equation modelling technique was employed for data analysis. RESULTS: The model fitted the data well: χ2 = 33.50 p = 0.12, CFI = 0.98, TLI = 0.97, RMSEA = 0.06, SRMR = 0.04. Professional competency was positively associated with both JS (β = 0.39) and OCB (β = 0.53). SIGNIFICANCE OF RESULTS: The more confidence palliative care nurses have in their professional competency, the more they are satisfied with their job and engage in OCB. Fostering professional competency in palliative nursing can help not only patients and their families, but also the nurses themselves, the organisation, and their co-workers

GLP-1 Mediates Regulation of Colonic ACE2 Expression by the Bile Acid Receptor GPBAR1 in Inflammation

Background & Aims: ACE2, a carboxypeptidase that generates Ang-(1-7) from Ang II, is highly expressed in the lung, small intestine and colon. GPBAR1, is a G protein bile acid receptor that promotes the release of the insulinotropic factor glucagon-like peptide (GLP)-1 and attenuates intestinal inflammation. Methods: We investigated the expression of ACE2, GLP-1 and GPBAR1 in two cohorts of Crohn’s disease (CD) patients and three mouse models of colitis and Gpbar1−/− mice. Activation of GPBAR1 in these models and in vitro was achieved by BAR501, a selective GPBAR1 agonist. Results: In IBD patients, ACE2 mRNA expression was regulated in a site-specific manner in response to inflammation. While expression of ileal ACE2 mRNA was reduced, the colon expression was induced. Colon expression of ACE2 mRNA in IBD correlated with expression of TNF-α and GPBAR1. A positive correlation occurred between GCG and GPBAR1 in human samples and animal models of colitis. In these models, ACE2 mRNA expression was further upregulated by GPABR1 agonism and reversed by exendin-3, a GLP-1 receptor antagonist. In in vitro studies, liraglutide, a GLP-1 analogue, increased the expression of ACE2 in colon epithelial cells/macrophages co-cultures. Conclusions: ACE2 mRNA expression in the colon of IBD patients and rodent models of colitis is regulated in a TNF-α-and GLP-1-dependent manner. We have identified a GPBAR1/GLP-1 mechanism as a positive modulator of ACE2

Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review

: Children and young adults (CYAs) with chronic conditions need to engage in self-care to improve their quality of life. This study aimed to retrieve the literature on instruments to assess self-care in CYAs living with chronic conditions and evaluate the psychometric proprieties of the instruments retrieved. A systematic literature review was conducted on six databases to identify peer-reviewed papers that described or used an evaluation instrument of self-care in CYAs with chronic conditions. Twenty-three articles describing 11 instruments of self-care were identified. Five instruments (45.45%) were developed for specific diseases, while six (54.54%) for various chronic illnesses. Most of the instruments were focused on treatment adherence within self-care maintenance (i.e., behaviors to maintain illness stability), excluding the monitoring of clinical parameters or the management of exacerbations. This review provides an overview of available instruments that measure self-care in CYAs with chronic conditions, which health professionals could use for patient education

Natural SINEUP RNAs in Autism Spectrum Disorders: RAB11B-AS1 Dysregulation in a Neuronal CHD8 Suppression Model Leads to RAB11B Protein Increase

CHD8 represents one of the highest confidence genetic risk factors implied in Autism Spectrum Disorders, with most mutations leading to CHD8 haploinsufficiency and the insurgence of specific phenotypes, such as macrocephaly, facial dysmorphisms, intellectual disability, and gastrointestinal complaints. While extensive studies have been conducted on the possible consequences of CHD8 suppression and protein coding RNAs dysregulation during neuronal development, the effects of transcriptional changes of long non-coding RNAs (lncRNAs) remain unclear. In this study, we focused on a peculiar class of natural antisense lncRNAs, SINEUPs, that enhance translation of a target mRNA through the activity of two RNA domains, an embedded transposable element sequence and an antisense region. By looking at dysregulated transcripts following CHD8 knock down (KD), we first identified RAB11B-AS1 as a potential SINEUP RNA for its domain configuration. Then we demonstrated that such lncRNA is able to increase endogenous RAB11B protein amounts without affecting its transcriptional levels. RAB11B has a pivotal role in vesicular trafficking, and mutations on this gene correlate with intellectual disability and microcephaly. Thus, our study discloses an additional layer of molecular regulation which is altered by CHD8 suppression. This represents the first experimental confirmation that naturally occurring SINEUP could be involved in ASD pathogenesis and underscores the importance of dysregulation of functional lncRNAs in neurodevelopment

Inhibition of Immune Synapse by Altered Dendritic Cell Actin Distribution: A New Pathway of Mesenchymal Stem Cell Immune Regulation

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A bottom-up approach to prioritize the scientific activities of Italian Association of Cancer Nurses (AIIAO): Questionnaire validation and pilot study

Introduction. There are no national data aimed to describe nurses' perception of variability in delivering nursing activities in relation to best practice and inequality in receiving nursing care. Moreover, there are no validated tools to be used in research. Therefore, the aims of this study are: a) to develop and validate a questionnaire to describe nurses' perceptions of variability and inequality in the oncology setting; b) to test content and face validity; c) to provide preliminary data (pilot study) to plan strategies for future national studies. Material and methods. This is a multi-phase and multi-method study. Phase 1 is focused on questionnaire's development (i.e., literature review and consensus discussion); phase 2 is aimed to determine content and face validity of the questionnaire; and phase 3 was a pilot data collection through an on-line survey. Results. The questionnaire that was developed yielded an adequate content and face validity (S-CVI=0.89 and CVR >0.60 for all items). The pilot study (75 nurses) found that nurse participants perceived as the most relevant categories pain and gastrointestinal and oral cavity dysfunctions. Fatigue, impairments of social function and psychological disorders were the areas in which greater variability and inequalities in receiving nursing care emerged. Overall, more than 50% of nurses reported variability and inequalities in oncology symptom management (in the investigated categories). Conclusions. The study results support the content validity of the questionnaire that can thereby be used for pan-national investigations

Generalizing Tanisaki's ideal via ideals of truncated symmetric functions

We define a family of ideals $I_h$ in the polynomial ring $\mathbb{Z}[x_1,...,x_n]$ that are parametrized by Hessenberg functions $h$ (equivalently Dyck paths or ample partitions). The ideals $I_h$ generalize algebraically a family of ideals called the Tanisaki ideal, which is used in a geometric construction of permutation representations called Springer theory. To define $I_h$, we use polynomials in a proper subset of the variables ${x_1,...,x_n}$ that are symmetric under the corresponding permutation subgroup. We call these polynomials {\em truncated symmetric functions} and show combinatorial identities relating different kinds of truncated symmetric polynomials. We then prove several key properties of $I_h$, including that if $h>h'$ in the natural partial order on Dyck paths then $I_{h} \subset I_{h'}$, and explicitly construct a Gr\"{o}bner basis for $I_h$. We use a second family of ideals $J_h$ for which some of the claims are easier to see, and prove that $I_h = J_h$. The ideals $J_h$ arise in work of Ding, Develin-Martin-Reiner, and Gasharov-Reiner on a family of Schubert varieties called partition varieties. Using earlier work of the first author, the current manuscript proves that the ideals $I_h = J_h$ generalize the Tanisaki ideals both algebraically and geometrically, from Springer varieties to a family of nilpotent Hessenberg varieties.Comment: v1 had 27 pages. v2 is 29 pages and adds Appendix B, where we include a recent proof by Federico Galetto of a conjecture given in the previous version. We also add some connections between our work and earlier results of Ding, Gasharov-Reiner, and Develin-Martin-Reiner. v3 corrects a typo in Valibouze's citation in the bibliography. To appear in Journal of Algebraic Combinatoric