Hospital volunteering experiences suggest that new policies are needed to promote their integration in daily care: Findings from a qualitative study

Objective: To explore Hospital Volunteers\u2019 (HVs) motivations and experiences, as well as the strategies they adopt to overcome challenging situations during volunteering and the needs they perceive. Methods: Eleven Italian HVs were purposively approached between January and July 2016, using face-to-face semi-structured interviews. The interviews were audio-recorded, transcribed verbatim and analysed using the descriptive phenomenological approach. Results: Hospital volunteering emerged as a complex experience characterised by five themes: (a) becoming a volunteer; (b) developing skills; (c) experiencing conflicting emotions; (d) overcoming role difficulties by enacting different resources and strategies; and (e) addressing emerging needs. Conclusions: According to the findings, hospital policies aimed at promoting volunteer integration in daily care are needed and should be based on (a) a shared vision between the hospital and the volunteer associations regarding the HVs\u2019 role and skills; (b) the development of integrated models of care combining different workforces (i.e. professionals and volunteer staff); (c) appropriate training of HVs at baseline; (d) individualised continuous education pathways aimed at supporting HVs both emotionally and in the development of the required skills; and (e) tailored education that is directed to health-care staff aimed at helping them to value the service provided by HVs

2,3,4,6-Tetra-O-acetyl-2-phthalimido-β-d-glucopyran­oside

In the crystal structure of the title compound, C24H27NO11, a substituted tetra­acetyl glucopyran­oside derivative, weak inter­molecular C—H⋯O hydrogen bonds link the mol­ecules into ribbons propagated in [010]. The d configuration has been attributed on the basis of the synthesis and the β anomer has been determined from the structure

Evaluation of pain in the paediatric patient admitted to sub-intensive care: a scoping review protocol

Background and aim: pain is considered as the 5th vital sign thus it's paramount that healthcare professionals are equipped with validated tools for his correct assessment. There are different paediatric pain assessment scales that take into account patients' age. Actually, the "Face, Legs, Activity, Cry, Consolability" (FLACC), Wong-Baker and NRS scales are regarded as the gold standard in low intensity clinical areas, while the COMFORT-Behavior (COMFORT-B) and Behavioral Pain Scale (BPS) ones are used for high intensity clinical areas where paediatric patients are sedated/intubated. It's unclear which pain assessment scale should be used in sub-intensive areas such as Sub-Paediatric Intensive Care Unit (Sub-PICU) e Sub-Neonatal Intensive Care Unit (Sub-NICU). The aim of this protocol is to map the literature in order to identify what evidences are available regarding the assessment of pain in the paediatric sub-intensive clinical areas. Research question: "What is the literature available on pain assessment in paediatric patients in sub-intensive clinical areas such as Sub-PICU and sub-NICU?". Source of evidence: literature search will be performed through the following databases: PubMed, Scopus, CINAHL, Cochrane Library, Open Dissertations (EBSCO) and DOAJ. Furthermore, Cochrane CENTRAL and ClinicalTrials.gov will also be included. Methods: this scoping review will be conducted in accordance to the Joanna Briggs Institute guidelines and the results presented through a PRISMA flowchart

[The quality of life as perceived by older people. Results of a phenomenological study]

Elderly Quality of life (QoL) is vulnerable because of the decline in physical and mental capacity, discharge from work, rupture of the family and isolation. Many QoL Scales are made for adults: there is little research investigating how older people perceive QOL

Visible and invisible caring in nursing from the perspectives of patients and nurses in the gerontological context

Scand J Caring Sci. 2013 Dec 4. doi: 10.1111/scs.12105. [Epub ahead of print] Visible and invisible caring in nursing from the perspectives of patients and nurses in the gerontological context. Canzan F1, Heilemann MV, Saiani L, Mortari L, Ambrosi E. Author information Abstract AIM: Just as in many countries all over the world, the number of older people in Italy has increased rapidly. Consequently, an increasing number of nurses are engaged in the care of older patients. However, due to a lack of understanding of how nurses and patients perceive caring, nursing care may be compromised. The aim of this study is to explore, describe and compare the perceptions of gerontological nurses and patients related to the dimensions of caring in nursing in an Italian hospital setting. METHODS: In this qualitative descriptive study, a variety of analytic techniques were used to analyse semi-structured interview data from a purposeful sample of 20 nurses and 20 patients from geriatric units in two different Italian hospitals. FINDINGS: Although both nurses and patients gave rich descriptions of caring experiences, patients described features of caring in nursing that were visible (including nurses' caring gestures, giving attention and being competent) while nurses predominantly emphasised aspects of caring that were relatively invisible (such as reflecting on the patient's past needs, evaluating the nursing care rendered, planning for more appropriate future nursing care, taking multiple complex contextual factors into account to protect the patient and being competent). CONCLUSION: Our data revealed more nuanced insight into the meaning of invisible and visible caring in nursing within the gerontological context than has been previously reported in the literature. This has implications for nursing education and practice because it may help nurses meet the actual needs of older patients in hospital settings

Epigenomic and somatic mutations of pituitary tumors with clinical and pathological correlations in 111 patients

Objective To profile clinically non-aggressive and aggressive pituitary adenomas (PAs)/pituitary neuroendocrine tumours (PitNETs) and pituitary carcinomas for somatic mutations and epigenetic alterations of genes involved in cell proliferation/differentiation, microRNAs (miRNA)/long noncoding RNA (LncRNA)-post-transcriptional regulators and therapy targets. Design Retrospective observational study. Patients and Measurements A total of 64 non-aggressive and 41 aggressive PAs/PitNETs and 6 pituitary carcinomas treated by endoscopic surgery with >= 1-year follow-up were included. Somatic mutations of 17 genes and DNA methylation of 22 genes were assessed. Ten normal pituitaries were used as control. Results We found at least one mutation in 17 tumours, including 6/64 non-aggressive, 10/41 aggressive PAs/PitNETs, and 1/6 pituitary carcinoma. AIP (N = 6) was the most frequently mutated gene, followed by NOTCH (4), and TP53 (3). Hypermethylation of PARP15, LINC00599, ZAP70 was more common in aggressive than non-aggressive PAs/PITNETs (p < .05). Lower levels of methylation of AIP, GNAS and PDCD1 were detected in aggressive PAs/PITNETs than non-aggressive ones (p < .05). For X-linked genes, males presented higher level of methylation of FLNA, UXT and MAGE family (MAGEA11, MAGEA1, MAGEC2) genes in aggressive vs. non-aggressive PAs/PITNETs (p < .05). In pituitary carcinomas, methylation of autosomal genes PARP15, LINC00599, MIR193 and ZAP70 was higher than in PAs/PITNETs, while X-linked genes methylation level was lower. Conclusions Somatic mutations and methylation levels of genes involved in cell proliferation/differentiation, miRNA/LncRNA-post-transcriptional regulators and targets of antineoplastic therapies are different in non-aggressive and in aggressive PAs/PitNETs. Methylation profile also varies according to gender. Combined genetic-epigenetic analysis, in association with clinico-radiological-pathological data, may be of help in predicting PA/PitNET behaviour

Il caring nella pratica: una teoria descrittiva

Per parlare del nursing come caring e, nello specifico, per sostenere la tesi secondo la quale un buon nursing \ue8 tutt\u2019uno con il caring, \ue8 necessario sviluppare un processo argomentativo capace di mostrare come il caring sia un\u2019attivit\ue0 complessa, multidimensionale che richiede \u201cpensiero, sentimento e azione competente\u201d. Il caring esprime azioni eticamente significative con le quali gli infermieri si occupano e si preoccupano dei pazienti. Se la scienza del nursing \ue8 la scienza del caring, diventa questione rilevante e significativa per la ricerca approfondire il tema della cura per cogliere l\u2019essenza di una buona pratica di cura infermieristica. Questo testo si propone un percorso sia di ricerca teoretica sia empirica sul caring infermieristico. La domanda di ricerca che ha guidato tutto il processo d\u2019indagine qui documentato \ue8: in che cosa consiste un buon caring infermieristico? Il gruppo di ricerca \ue8 costituito da due ricercatrici accademiche e sei infermiere interessate ad apprendere il lavoro di ricerca nella pratica. La scelta di un gruppo misto \ue8 motivata dal fatto che indagare sulla cultura dei pratici senza la loro mediazione non avvicina all\u2019essenza. La ricerca di matrice fenomenologica ha chiesto ai pratici di dar voce al loro pensiero sull\u2019attivit\ue0 di caring, di interpellare la loro esperienza attraverso la narrazione; sulle loro parole piene di realt\ue0 i ricercatori hanno ricostruito il significato e una concettualizzazione del caring infermieristico

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Introduzione alla ricerca qualitativa: i principali metodi e sistemi di campionamento

Vengono brevemente presentati i principali metodi di ricerca qualitativa (fenomenologico, etnografico, Grounded Theory, narrative e studio di casi ed i più utilzzati tipi di campionamento) illustrando per ciascuno le principali caratteristiche anche con un esempi

Expression of pyoverdine genes in Pseudomonas aeruginosa PAO1: intracellular levels of PvdS

In response to iron-limitation, Pseudomonas aeruginosa PAO1 produces the fluorescent siderophore pyoverdine. Transcription of pyoverdine biosynthetic (pvd) genes depends on the extracytoplasmic function (ECF) sigma factor PvdS, which is negatively regulated by the Fur repressor. An additional level of regulation of pvd genes relies upon the surface signalling mechanism that involves the ferripyoverdine outer membrane receptor FpvA and the pyoverdine molecule itself. In the absence of ferripyoverdine, the activity of PvdS is antagonized by the antisigma factor FpvR. Binding of ferripyoverdine to FpvA initiates a signal transduction cascade that involves FpvR and leads to the transcription of several virulence genes (e.g. pvd, aprA, prpL and toxA) by PvdS-dependent RNA polymerase. To evaluate the competition between PvdS and the major sigma subunit RpoD (s70) for RNA polymerase binding, we have determined the intracellular levels of PvdS and RpoD in iron-starved P. aeruginosa PAO1 cells during the exponential and stationary phase. By means of quantitative immunoblot analysis, we found that PvdS attains 60% of RpoD levels in exponential phase, while it drastically decreases at the stationary phase. PvdS also exhibits reduced stability in the presence of an excess of iron in vivo. Experiments are in progress to investigate the effect surface signalling components on PvdS activity and stability