Il profilo del laureato magistrale in scienze infermieristiche e ostetriche in Italia: dall\u2019analisi dei regolamenti didattici d\u2019ateneo alle competenze distintive

Introduzione L\u2019obiettivo dello studio \ue8 quello di descrivere le competenze distintive dell\u2019infermiere laureato magistrale ed evidenziare nuovi spazi di esercizio professionale di tale figura in rapporto alle necessit\ue0 delle organizzazioni sanitarie. Materiale e metodi Lo studio \ue8 di tipo descrittivo-correlazionale (cross-sectional). Lo strumento utilizzato per l\u2019analisi degli obiettivi formativi qualificanti dei regolamenti didattici di ateneo \ue8 stata una griglia di lettura costruita ex novo dal gruppo di lavoro. Risultati Lo studio ha interessato la documentazione di 29 sedi universitarie italiane nel periodo 2012-2013. L\u2019infermiere laureato magistrale \ue8 un professionista con competenze manageriali, in linea con il mandato formativo dei corsi di laurea magistrale in scienze infermieristiche e ostetriche (CLMSIO), ma dall\u2019analisi dei risultati emergono sei profili differenti di infermiere laureato magistrale. L\u2019ipotesi che sulla diversificazione dei curricula abbiano agito due predittori, ovvero la pregressa presenza, nella medesima universit\ue0, di una scuola diretta a fini speciali per dirigente dell\u2019assistenza infermieristica (DAI/IID) e/o la presenza di un coordinatore o docente di riferimento appartenente al settore di scienze infermieristiche generali, cliniche e pediatriche (MED/45), \ue8 stata dimostrata nulla dal test di ANOVA (Kruskal-Wallis). Conclusioni In funzione ai bisogni di assistenza socio-sanitaria, \ue8 urgente rendere la formazione dell\u2019infermiere laureato magistrale pi\uf9 flessibile e dinamica, diversificando il percorso formativo verso una pratica infermieristica avanzata, anche al fine di migliorare gli sbocchi occupazionali

Effects of a Synbiotic Formula on Functional Bowel Disorders and Gut Microbiota Profile during Long-Term Home Enteral Nutrition (LTHEN): A Pilot Study

Long-term enteral nutrition (LTEN) can induce gut microbiota (GM) dysbiosis and gastrointestinal related symptoms, such as constipation or diarrhoea. To date, the treatment of constipation is based on the use of laxatives and prebiotics. Only recently have probiotics and synbiotics been considered, the latter modulating the GM and regulating intestinal functions. This randomized open-label intervention study evaluated the effects of synbiotic treatment on the GM profile, its functional activity and on intestinal functions in long-term home EN (LTHEN) patients. Twenty LTHEN patients were recruited to take enteral formula plus one sachet/day of synbiotic (intervention group, IG) or enteral formula (control group, CG) for four months and evaluated for constipation, stool consistency, and GM and metabolite profiles. In IG patients, statistically significant reduction of constipation and increase of stool consistency were observed after four months (T1), compared to CG subjects. GM ecology analyses revealed a decrease in the microbial diversity of both IC and CG groups. Biodiversity increased at T1 for 5/11 IG patients and Methanobrevibacter was identified as the biomarker correlated to the richness increase. Moreover, the increase of short chain fatty acids and the reduction of harmful molecules have been correlated to synbiotic administration. Synbiotics improve constipation symptoms and influences Methanobrevibacter growth in LTHEN patients

Implementation of the ERAS (Enhanced Recovery after Surgery) protocol for colorectal cancer surgery in the Piemonte Region with an Audit and Feedback approach: Study protocol for a stepped wedge cluster randomised trial: A study of the EASY-NET project

Introduction The ERAS protocol (Enhanced Recovery After Surgery) is a multimodal pathway aimed to reduce surgical stress and to allow a rapid postoperative recovery. Application of the ERAS protocol to colorectal cancer surgery has been limited to a minority of hospitals in Italy. To promote the systematic adoption of ERAS in the entire regional hospital network in Piemonte an Audit and Feedback approach (A&F) has been adopted together with a cluster randomised trial to estimate the true impact of the protocol on a large, unselected population. Methods A multicentre stepped wedge cluster randomised trial is designed for comparison between standard perioperative management and the management according to the ERAS protocol. The primary outcome is the length of hospital stay (LOS). Secondary outcomes are: incidence of postoperative complications, time to patients' recovery, control of pain and patients' satisfaction. With an A&F approach the adherence to the ERAS items is monitored through a dedicated area in the study web site. The study includes 28 surgical centres, stratified by activity volume and randomly divided into four groups. Each group is randomly assigned to a different activation period of the ERAS protocol. There are four activation periods, one every 3 months. However, the planned calendar and the total duration of the study have been extended by 6 months due to the COVID-19 pandemic. The expected sample size of about 2200 patients has a high statistical power (98%) to detect a reduction of LOS of 1 day and to estimate clinically meaningful changes in the other endpoints. Ethics and dissemination The study protocol has been approved by the Ethical Committee of the coordinating centre and by all participating centres. Study results will be timely circulated within the hospital network and published in peer-reviewed journals. Trial registration number NCT04037787