The Perceptions of Professional Values among Students at a Spanish Nursing School

(1) Background: This study aims to reflect student nurses' perceptions of professional values across the four training years. (2) Methods: This study was designed as a cross-sectional study; data were collected using the Nurses' Professional Values Scale-Revised, adapted by Basurto-Hoyuelos. A total of 315 student nurses participated from a Nursing Faculty in Spain representing each of the four academic years. (3) Results: Students' perceptions of professional values were significantly correlated with their academic year. Overall, students' scores were higher in the ethics dimension. The two highest scores were for Maintain patient confidentiality for years 1 and 2 (4.77 and 4.68, respectively) and Safeguard patients' right to privacy for years 3 and 4 (4.95 and 4.98, respectively). Lower scores were observed in the professional expertise dimension across all years, and corresponded to a single item Participate in peer review (3.51, 3.38, 3.98, and 3.26, respectively). (4) Conclusions: This study is relevant as it highlights how nursing students' perceptions of professional values change overtime, even during the four years of their training. The ethics dimension was the most highly regarded across all academic years. However, the professional expertise dimension requires greater attention throughout the degree as students regarded it as less important for their immediate future

Enhanced Vascular Endothelial Growth Factor Gene Expression in Ischaemic Skin of Critical Limb Ischaemia Patients

Objectives. To perform a quantitative analysis of the vascular endothelial growth factor (VEGF) gene transcription in the skin of ischemic legs and provide information for VEGF in the pathogenesis in critical limb ischemia (CLI). Methods. Skin biopsies were obtained from 40 patients with CLI. Control samples came from 44 patients with chronic venous disease. VEGF gene expression was analysed using quantitative polymerase chain reaction. Results. Patients with CLI had higher skin VEGF expression than control group (RQ: 1.3 ± 0.1 versus 1, P = 0.04). Conclusions. We found an association between ischemic skin and an elevated VEGF expression in legs from patients with CLI. These data support that the mechanism for VEGF upregulation in hypoxia conditions is intact and acts appropriately in the ischaemic limbs from patients with CLI

A prospective randomized controlled study with intermittent mechanical compression of the calf in patients with claudication

ObjectivesThe study tested the feasibility of using a new portable mechanical compression device for the treatment of claudication. The device applies intermittent non-pneumatic mechanical compression (IMC) to the calf. It was hypothesized that it can offer a low-cost convinient option for patients and achieve good compliance and improved clinical outcomes.MethodsThirty patients were enrolled in a randomized controlled single blind study. Fourteen patients were assigned to active IMC. Sixteen control patients continued with medical treatment alone. Outcomes were recorded at baseline, after one month, three months, and six months. The study examined changes in exercise tolerance using Initial Claudiacation Distance (ICD) and Absolute Claudiaction Distance (ACD) as well as ankle-brachial index at rest (ABI-r) and post-exercise (ABI-pe). All patients had stable claudication due to peripheral arterial disease (PAD) and were already under best medical treatment (BMT). To be eligible for inclusion, patients had to be between the ages of 50 and 75 years, had to have stable claudication with an absolute claudication distance >40 meters but <300 meters on a standardized treadmill stress test (3.8 km/h at a 10% grade), have a resting ABI in the affected limb <0.8 with a drop of at least 0.15 following exercise, in whom surgical intervention was not expected for at least three months. Fourteen patients were assigned to active IMC consisting of compressions 65 mm Hg in amplitude, applied for three 3-second compressions/minute, two hours/day for three months. Sixteen control patients continued with BMT alone.ResultsOne month after treatment, ICD increased by 66% (P = .001), ACD increased by 51.75% (P = .005), and ABI-pe increased by 42% (P = .01). Treatment effects were maintained or further improved after three months. ABI-r did not increase at any time. Compliance exceeded 80%. Three months following cessation of therapy, claudication distances and ABI-pe did not decrease significantly.ConclusionsWe concluded that the use of IMC of the calf for three months increased claudication distances and led to objective improvements in ABI-pe. Intermittent mechanical compression may be a useful approach to patients with continued claudication despite standard medical treatment

Clinical Study Results of Infrapopliteal Endovascular Procedures Performed in Diabetic Patients with Critical Limb Ischemia and Tissue Loss from the Perspective of an Angiosome-Oriented Revascularization Strategy

Our aim was to describe our experience with infrapopliteal endovascular procedures performed in diabetic patients with ischemic ulcers and critical ischemia (CLI). A retrospective study of 101 procedures was performed. Our cohort was divided into groups according to the number of tibial vessels attempted and the number of patent tibial vessels achieved to the foot. An angiosome anatomical classification of ulcers were used to describe the local perfusion obtained after revascularization. Ischemic ulcer healing and limb salvage rates were measured. Ischemic ulcer healing at 12 months and limb salvage at 24 months was similar between a single revascularization and multiple revascularization attempts. The group in whom none patent tibial vessel to the foot was obtained presented lower healing and limb salvage rates. No differences were observed between obtaining a single patent tibial vessel versus more than one tibial vessel. Indirect revascularization of the ulcer through arterial-arterial connections provided similar results than those obtained after direct revascularization via its specific angiosome tibial artery. Our results suggest that, in CLI diabetic patients with ischemic ulcers that undergo infrapopliteal endovascular procedures, better results are expected if at least one patent vessel is obtained and flow is restored to the local ischemic area of the foot

Treatment of thromboangiitis obliterans (Buerger's disease) with bosentan

<p>Abstract</p> <p>Background</p> <p>This study assessed the effectiveness and safety of bosentan when administered to thromboangiitis obliterans (Buerger's disease) patients.</p> <p>Methods</p> <p>A clinical pilot study was designed in which patients with ulcer and/or pain at rest were treated with bosentan p.o. at a dose of 62.5 mg twice daily during the first month, which was thereafter up-titrated to 125 mg twice daily. The study endpoints were clinical improvement rate, major or minor amputation rate, haemodynamic changes, changes in endothelial function and angiographic changes.</p> <p>Results</p> <p>Seven out of 12 patients were male (58%). Median age was 39 years (range 29-49). The median follow-up was 20 months (range 11-40). All patients were smokers. With bosentan treatment, new ischaemic lesions were observed in only one patient. Overall, clinical improvement was observed in 12 of the 13 extremities (92%). Only two out of 13 extremities underwent amputation (one major and one minor) after bosentan treatment. After being assessed by digital arteriography with subtraction or angio-magnetic resonance imaging, an increase of distal flow was observed in 10 out of the 12 patients. All patients experienced a statistically significant improvement in their BAFMD values (mean: 1.8 at baseline; 6.6 at the end of the treatment; 12.7 three months after the end of the treatment; p < 0.01).</p> <p>Conclusion</p> <p>Bosentan treatment may result in an improvement of clinical, angiographic and endothelial function outcomes. Bosentan should be investigated further in the management of TAO patients. Larger studies are required to confirm these results.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01447550">NCT01447550</a></p

Los valores profesionales en el grado de enfermaría

INTRODUCCIÓ: Els valors professionals es defineixen com a valors humans contextualitzats orientats a la professió, constitueixen la identitat professional i s'adquireixen principalment mitjançant la formació acadèmica i la pràctica clínica. El principal objectiu d'aquesta investigació ha estat analitzar la percepció respecte als valors professionals dels estudiants d'una escola d'infermeria de Barcelona (Espanya). METODOLOGIA: La present investigació és un estudi de cas on s'ha emprat metodologia mixta seguint un disseny de triangulació concurrent (DITRIAC). Van participar tres cent quinze estudiants dels quatre cursos que conformen el grau d'infermeria. Amb la intenció de donar resposta als objectius plantejats, es van utilitzar dos instruments: per a l'abordatge quantitatiu es va emprar l'Escala de Valors Professionals d'Infermeria (EVPE) validada a Espanya per Basurto (2010) i per a l'abordatge qualitatiu es va dissenyar un qüestionari ad hoc que va incloure 13 comportaments relacionats amb els valors professionals (CCEUG). RESULTATS: La taxa de resposta va ser de 65.9%. La puntuació mitjana obtinguda pels estudiants en l'Escala de valors (EVPE) va ser de 113,35 sent el rang de puntuació possible entre 26 i 130. Es va analitzar la fiabilitat de l'escala i es va obtenir un coeficient alfa de Cronbach de ,926. Després d'analitzar la relació de l'escala amb les sis variables sociodemogràfiques de la mostra d'estudiants, es van obtenir diferències estadísticament significatives en dues d'elles: 1) Curs Acadèmic i 2) Anys d'experiència laboral en Ciències de la Salut. Les puntuacions més elevades es van obtenir en la Dimensió Ètica. L'abordatge qualitatiu ens va permetre identificar els valors que guien els comportaments dels estudiants en les seves pràctiques clíniques segons la seva pròpia percepció, així com els factors facilitadors, inhibidors i ambivalents associats a aquests comportaments. CONCLUSIONS: Aquest estudi ha demostrat que la percepció de la importància dels valors en estudiants d'infermeria és alta, encara que s'incrementa al llarg dels dos últims cursos. El principal valor que guia la seva conducta durant les pràctiques és el respecte a la dignitat humana per a tots els cursos, encara que en cursos superiors augmenta el ventall de valors identificats. S'han identificat diversos factors que inhibeixen o afavoreixen els comportaments dels estudiants associats als valors. Per tot això considerem necessari intensificar la formació en valors professionals al llarg del grau amb la intenció de millorar la qualitat de l'atenció dels futurs professionals.INTRODUCCIÓN: Los valores profesionales se definen como valores humanos contextualizados orientados a la profesión, constituyendo la identidad profesional y se adquieren principalmente mediante la formación académica y la práctica clínica. El principal objetivo de esta investigación ha sido analizar la percepción respecto a los valores profesionales de los estudiantes de una escuela de enfermería de Barcelona (España). METODOLOGÍA: La presente investigación es un estudio de caso para el que se han utilizado metodología mixta siguiendo un diseño de triangulación concurrente (DITRIAC). Participaron tres ciento quince estudiantes de los cuatro cursos que conforman el grado de enfermería. Con la intención de dar respuesta a los objetivos planteados, se utilizaron dos instrumentos: para el abordaje cuantitativo se utilizó la Escala de Valores Profesionales de Enfermería (EVPE) validada en España por Basurto (2010) y para el abordaje cualitativo se diseñó un cuestionario ad hoc que incluyó 13 comportamientos relacionados con los valores profesionales (CCEUG). RESULTADOS: La tasa de respuesta fue de 65,9%. La puntuación media obtenida por los estudiantes en la Escala de valores (EVPE) fue de 113,35 siendo el rango de puntuación posible entre 26 y 130. Se analizó la fiabilidad de la escala y se obtuvo un Coeficiente alfa de Cronbach de ,926. Tras analizar la relación de la escala con las seis variables sociodemográficas de la muestra de estudiantes, se obtuvieron diferencias estadísticamente significativas en dos de ellas: 1) Curso Académico y 2) Años de experiencia laboral en Ciencias de la Salud. Las puntuaciones más elevadas se obtuvieron en la Dimensión Ética. El abordaje cualitativo nos permitió identificar los valores que guían los comportamientos de los estudiantes en sus prácticas clínicas según su propia percepción, así como los factores facilitadores, inhibidores y ambivalentes asociados a estos comportamientos. CONCLUSIONES: Este estudio ha demostrado que la percepción de la importancia de los valores en estudiantes de enfermería es alta, aunque se incrementa a lo largo de los dos últimos cursos. El principal valor que guía su conducta durante las prácticas es el respeto a la dignidad humana para todos los cursos, aunque en cursos superiores aumenta el abanico de valores identificados. Diversidad de factores inhiben o favorecen los comportamientos de los estudiantes asociados a los valores. Por todo ello consideramos necesario intensificar la formación en valores profesionales a lo largo del grado con la intención de mejorar la calidad de la atención de los futuros profesionales.BACKGROUND: Professional values are defined as contextualized human values oriented to the profession, constituting the professional identity and are acquired mainly through academic training and clinical practice. The main objective of this research has been to analyze the perception regarding the professional values of the students of a nursing school in Barcelona (Spain). METHODOLOGY: This research is a case study for which mixed methodology has been used following a concurrent triangulation design (DITRIAC). Three hundred and fifteen students from the four courses that make up the nursing degree participated. With the intention of responding to the proposed objectives, two instruments were used: for the quantitative approach, the Professional Nursing Values Scale (EVPE) validated in Spain by Basurto (2010) was used and for the qualitative approach, a questionnaire specifically designed for research that included 13 behaviors related to professional values (CCEUG). RESULTS: The response rate was 65.9%. The mean score obtained by the students on the Scale of Values (EVPE) was 113.35, the range of possible scores being between 26 and 130. The reliability of the scale was analyzed and a Cronbach's alpha coefficient of .926 was obtained. After analyzing the relationship of the scale with the six sociodemographic variables of the student sample, statistically significant differences were obtained in two of them: 1) Academic year and 2) Years of work experience in Health Sciences. The highest scores were obtained in the Ethical Dimension. The qualitative approach allowed us to identify the values that guide the behaviors of the students in their clinical practices according to their own perception, as well as the facilitating, inhibiting and ambivalent factors associated with these behaviors. CONCLUSIONS: This study has shown that the perception of the importance of values in nursing students is high, although it increases over the last two years. The main value that guides their conduct is respect for human dignity for all courses, although in higher courses the range of identified values increases. Certain factors influence student behaviors associated with values. For all these reasons, we consider it necessary to intensify training in professional values throughout the degree with the intention of improving the quality of care for future professionals.Universitat Autònoma de Barcelona. Programa de Doctorat en Educaci

Papel de los inflamasomas en la enfermedad arterial periférica

Tesis inédita presentada en la Universidad Europea de Madrid. Escuela de Doctorado e Investigación. Programa de Doctorado en Biomedicina y Ciencias de la SaludUE

The Perceptions of Professional Values among Students at a Spanish Nursing School

(1) Background: This study aims to reflect student nurses' perceptions of professional values across the four training years. (2) Methods: This study was designed as a cross-sectional study; data were collected using the Nurses' Professional Values Scale-Revised, adapted by Basurto-Hoyuelos. A total of 315 student nurses participated from a Nursing Faculty in Spain representing each of the four academic years. (3) Results: Students' perceptions of professional values were significantly correlated with their academic year. Overall, students' scores were higher in the ethics dimension. The two highest scores were for Maintain patient confidentiality for years 1 and 2 (4.77 and 4.68, respectively) and Safeguard patients' right to privacy for years 3 and 4 (4.95 and 4.98, respectively). Lower scores were observed in the professional expertise dimension across all years, and corresponded to a single item Participate in peer review (3.51, 3.38, 3.98, and 3.26, respectively). (4) Conclusions: This study is relevant as it highlights how nursing students' perceptions of professional values change overtime, even during the four years of their training. The ethics dimension was the most highly regarded across all academic years. However, the professional expertise dimension requires greater attention throughout the degree as students regarded it as less important for their immediate future