L’arsenico nell’antichità e ai giorni nostri

L’argomento di questo lavoro è stato suggerito alle autrici dal ruolo negativo che attualmente l’arsenico sta svolgendo, quasi sempre in maniera del tutto naturale, avvelenando le acque che vengono a contatto, all’aria, con le rocce che lo contengono. Il fenomeno, quasi certamente presente anche nei tempi passati, è stato rilevato recentemente in diverse aree del globo, anche come conseguenza delle attività antropiche, soprattutto in Bangladesh dove decine di milioni di persone consumano abitualmente acqua con un alto contenuto di tale sostanza. Si è voluto analizzare il ruolo che questo metallo ha avuto nell’antichità studiando i testi di autori classici che lo trattano, a volte con nomi diversi come Orpimento o Sandracca, e si è visto che esso, pur essendo tossico, è stato usato anche come farmaco. In tempi più recenti le sue applicazioni sono aumentate soprattutto in campo industriale. Lo studio vuole mettere a confronto gli usi del passato con quelli attuali e rilevare gli effetti ambientali da essi generati

Evaluation of empathy among undergraduate nursing students: a three-year longitudinal study

Background and aim: An empathic approach is considered fundamental in order to ensure the identification of patient needs and to provide the appropriate care, although the studies on the development of empathic attitude during nursing course reported conflicting results. Different empathic tendencies have been observed in the two genders: many studies showed greater empathy in females. Methods: To assess empathy level of students enrolled in the academic year 2015/16 at an Italian University nursing course, the Balanced Emotional Empathy Scale (BEES) was administered at the start of Year 1 (n=118), at the mid-point of Year 2 (n=99) and at the end of Year 3 (n=67). Data were statistically analyzed. Results: Cronbach’s values were satisfactory (0.87 at Year 1, 0.89 at Year 2, 0.79 at Year 3), confirming the good internal reliability of BEES. The nursing students obtained a total BEES mean ± SD score of 37.0 ± 19.5 at Year 1, 33.5 ± 22.6 at Year 2 and 35.4 ± 16 at Year 3, without any statistically significant difference among the three years. The BEES mean scores reported by males were lower in comparison with females during the three years of the course, although, at the end of the third year, males showed a significant increase at the “Emotional spread responsiveness” dimension of the scale. Conclusions: The study suggests that empathy can be maintained at good levels during the nursing education especially if nursing teaching and internship are focused on this topic, acting up the innate aptitude of each student

Perceptions of Caring Behavior Among Undergraduate Nursing Students: A Three-Cohort Observational Study

Introduction: Increase in the knowledge of “caring science” among nurses plays a key role in ensuring a correct caring behavior towards patients. Caring training for students is a priority in nursing education, but unfortunately there are limited and conflicting studies which explore this outcome. The purpose of this observational study was to explore the perceptions of caring behaviors by nursing students during their clinical practice training in order to highlight if the level of caring behaviors changes as the nursing course progresses. Materials and Methods: The Caring Behaviors Inventory-24 (CBI-24) was administered to 331 students, enrolled in the three years of an Italian Nursing Course, who accepted to participate in the study (89.2% response rate). The data were analyzed using SPSS software version 26.0 (SPSS Inc., Chicago, IL). Results: The total mean score of CBI-24 was 4.82 in the first, 5.12 in the second and 5.26 in the third-year students. The CBI-24 dimensions “Responding to individual needs” and “Being with” obtained the highest scores among the students of the first year. At the end of the first year, our students were already able to perform expressive caring, whereas instrumental caring developed at a high level in the second and third years. We did not highlight any statistically significant difference between the two gender CBI-24 item scores. Conclusion: In light of our results, we put in evidence that Nursing Degree Programme favours the development in students of both relational and technical components of caring behaviors. We hope that in future students’ self-assessment of caring behaviors could be considered an educational outcome for Nursing Programme

Nursing student attitudes toward dying patient care: A European multicenter cross-sectional study

Background and aim of the work: Nursing education plays a key role in preparing future nurses to deal with dying patients, which represents one of the most emotionally involving aspect of nursing. The aims of the study were to explore nursing students’ attitudes towards care of dying patients in three different European contexts and to analyze the variables that can influence them. Methods: We conducted an international mul- ticenter cross-sectional study. We administered the Frommelt Attitude Toward Care of the Dying Scale form B (FATCOD-B) and a demographic form to 569 students, enrolled in three Nursing Programmes in different countries (Italy, Spain and United Kingdom), who accepted to participate in the study. The data were analyzed using SPSS software version 26.0. Results: Median total FATCOD-B scores indicated intermediate levels of students’ attitudes towards care for dying patients, with a statistically significant difference among the three student groups. The median total FATCOD-B scores did not statistically significantly change in students with different age, gender, year of study, religious beliefs, nursing education on palliative care, previous expe- riences of dying patient care and personal grieving. Conclusions: In our study, nursing students feel partially prepared in caring for dying patients and their attitudes do not change as the course of study progresses. No selected variables had an impact on students’ attitudes towards palliative care. Since nurses play a vital role in ensuring the quality of care, education on end-of-life care should be offered as a core part of undergraduate nursing programs

Violence against nurses in the triage area: a mixed-methods study

Introduction Workplace violence is a serious occupational problem among nurses in emergency departments. The aim of this study was to better understand workplace violence experienced by triage nurses. Methods A mixed-methods study was carried out with 27 Italian nurses involved in the triage area of an emergency department. Quantitative data were collected using the Violent Incident Form and qualitative data were obtained from 3 focus groups. Results Ninety-six percent of triage nurses had suffered an episode of violence during the previous year. Participants reported that perpetrators of violence were primarily patients' relatives or friends (62%), usually male and in a lucid state of consciousness. The aggressor was a male patient in 31% of violent episodes. Male nurses reported only verbal abuse, unlike female nurses who suffered both physical and verbal episodes. Females received assistance from other staff during the aggression event more frequently than males, and females more frequently suffered from physical injury. Only physical and verbal aggressions were associated with physical injury. Four main themes emerged from the focus groups. Discussion Nurses reported that high exposure to workplace violence in triaging had significant consequences on their psychological well-being and on their behavior at work and at home. Violence, perceived as a personal and/or professional injury owing to insufficient organizational support, led professionals to experience feelings of resignation and to believe that abuse was an inevitable part of the job. Nevertheless, in our study, the precipitating factors were investigated, suggesting several possible solutions to limit this phenomenon

Nursing students’ evaluation of clinical learning environment and supervision models before and during the COVID-19 pandemic: a comparative study

Background and aim: The COVID-19 pandemic has required a rapid reorganization of clinical training and supervision models for nursing education. The aim of this study was to compare students’ levels of perception of the quality of the Clinical Learning Environment (CLE) using two different clinical su pervision models. Methods: A comparative design was implemented. A convenience sample of second and third-year undergraduate nursing students (n=127) in clinical training in the 2018/2019 Academic Year (AY) received the usual nursing staff supervision model, while during the COVID-19 pandemic in the following year, they (n=72) received an individualized supervision model. Data were collected using three instruments: the Clinical Learning Environmental Quality Evaluation Index (CLEQI); the Clinical Learning Environ ment, Supervision and Nurse Teacher Scale (CLES+T); and a socio-demographic tool. Results: The mean total scores of both scales had increased in the second survey (CLEQI: M=57.88±11.8 vs. M=60.88±9.3, p=0.035; CLES+T: M=148.4±23.3 vs. M=154.5±21.9, p=0.037). The nursing students reported high levels of CLE quality with both supervision models, even though the individualized supervision model was rated significantly higher by the students than the staff supervision model. Conclusions: Students supported by a personal supervisor during clinical training had a more positive experience and rated the quality of the tutorial strategies, learning opportunities, safety and nursing care, leadership style of the ward manager and overall CLE more highl

Hyper-activation of notch3 amplifies the proliferative potential of rhabdomyosarcoma cells.

Rhabdomyosarcoma (RMS) is a pediatric myogenic-derived soft tissue sarcoma that includes two major histopathological subtypes: embryonal and alveolar. The majority of alveolar RMS expresses PAX3-FOXO1 fusion oncoprotein, associated with the worst prognosis. RMS cells show myogenic markers expression but are unable to terminally differentiate. The Notch signaling pathway is a master player during myogenesis, with Notch1 activation sustaining myoblast expansion and Notch3 activation inhibiting myoblast fusion and differentiation. Accordingly, Notch1 signaling is up-regulated and activated in embryonal RMS samples and supports the proliferation of tumor cells. However, it is unable to control their differentiation properties. We previously reported that Notch3 is activated in RMS cell lines, of both alveolar and embryonal subtype, and acts by inhibiting differentiation. Moreover, Notch3 depletion reduces PAX3-FOXO1 alveolar RMS tumor growth in vivo. However, whether Notch3 activation also sustains the proliferation of RMS cells remained unclear. To address this question, we forced the expression of the activated form of Notch3, Notch3IC, in the RH30 and RH41 PAX3-FOXO1-positive alveolar and in the RD embryonal RMS cell lines and studied the proliferation of these cells. We show that, in all three cell lines tested, Notch3IC over-expression stimulates in vitro cell proliferation and prevents the effects of pharmacological Notch inhibition. Furthermore, Notch3IC further increases RH30 cell growth in vivo. Interestingly, knockdown of Notch canonical ligands JAG1 or DLL1 in RMS cell lines decreases Notch3 activity and reduces cell proliferation. Finally, the expression of Notch3IC and its target gene HES1 correlates with that of the proliferative marker Ki67 in a small cohort of primary PAX-FOXO1 alveolar RMS samples. These results strongly suggest that high levels of Notch3 activation increase the proliferative potential of RMS cells

Notch1 and HEY1 nuclear protein staining is positive in primary RMS tissues.

<p>Representative immunohistochemical staining showing expression of Notch1 and HEY1 in alveolar (ARMS; PAX-FOXO1-positive) and embryonal (ERMS) RMS tissue sections (200X Magnification). The lower pictures depict selected regions at higher magnification (600X) for each marker. Black and red arrows indicate nuclei either positive (brown) or negative (blue-violet) for each marker, respectively. Green arrows: Notch1 cytoplasmic staining. Left panels report the immunohistochemistry for each marker in normal skeletal muscle used as control tissue, in which myofibers' nuclei are negative for the two markers. A Notch1-positive nucleus of vessel cell was highlighted with black arrow.</p

Immunohistochemical Scoring of Notch Signaling Components in the whole cohort of pediatric patients with rhabdomyosarcomas (RMS) and in alveolar (PAX3-FOXO1, n = 10; PAX7-FOXO1, n = 2) and embryonal (n = 20) RMS subtypes.

<p>Data are expressed as median values semi-quantified as the percentage of positive nuclei per microscopic field (range in parentheses). Alveolar tumors were confirmed as PAX-FOXO1 fusion positive and Embryonal tumors as PAX-FOXO1 fusion-negative).</p><p>*<i>P</i>: Mann-Whitney test for ARMS <i>vs</i> ERMS values;</p>†<p><i>P</i> and ‡<i>P</i>: Fisher's exact test for Notch3 <i>vs</i> Notch1 and HES1 <i>vs</i> HEY1 values within each RMS subtype, respectively.</p

Forced expression of Notch3IC in PAX3-FOXO1 alveolar RH30 cells favors tumor growth <i>in vivo</i>.

<p>A, nude mice were injected with RH30-Notch3IC or RH30-Vector cells and the volume of tumor xenografts was monitored for 34 days (Right), after which xenografts were surgically removed (Left). Right, mean of tumor volumes (n = 5 mice/group) was calculated and plotted against time in days (RH30-Notch3IC vs RH30-Vector xenograft volumes: P = 0.036 at the 4th day and P = 0.009 for each other time point, Kruskal Wallis test). B, Left, Western blot showing levels of Notch3IC in a pool of 3 xenografts each from mice inoculated with RH30-Notch3IC and RH30-vector cells and excised 16 and 34 days after the first measurement. Actin was the loading control; Right, Histograms depict the densitometric analysis of the western blot shown in the left panel. Columns, means; Bars, SD.</p