Search

ObjectiveTo explore nursing students’ interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences.DesignNational cross-sectional study on data collected in 2016.Setting95 Bachelor of Nursing Sciences programmes; 27 Italian Universities.ParticipantsStudents who (a) were attending or just completed their clinical rotations lasting at least 2 weeks in the same unit, and (b) willing to participate in the study.Primary and secondary outcomesFirst to measure the occurrence of IPE experiences in the most recent clinical rotation; the secondary outcome was to discover factors associated with IPE occurrence.MeasuresThe primary outcome was measured using questions based on a 4-point Likert scale (from 0=‘never’ to 3=‘always’). Explanatory variables were collected at both individual and regional levels with items included in the same questionnaire.Results9607 out of 10 480 students took part in the study. Overall, 666 (6.9%) perceived not having had any IPE experience, while 3248 (33.8%), 3653 (38%) and 2040 (21.3%) reported having experienced IPE opportunities ‘only a little’, to ‘some extent’ or ‘always’, respectively. From the multilevel analysis performed using the generalised linear mixed model, factors promoting the occurrence of IPE experiences were mainly set at (a) the clinical learning environment level (high: learning environment quality, self-directed learning encouragement, learning opportunities, quality of safety and nursing care and quality of tutorial strategies); and (b) the regional level, where significant differences emerged across regions. In contrast, male gender was negatively associated with the perception of having had IPE experiences.ConclusionsA large number of nursing students experienced either ‘never’ or ‘only a little’ IPE opportunities, thus suggesting that nursing education tends to remain within the nursing profession. Limiting students’ interprofessional exposure during education can prevent future collaborative approaches that have been shown to be essential in providing best patient care. In order to increase IPE exposure, it is necessary to develop strategies designed both at the singular unit and regional levels.

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.This study aims to explore and understand the perceptions that older people have about their QOL.A qualitative research hermeneutics-phenomenological was done. Narratives were analyzed by mixed method phenomenological-grounded (Mortari, 2007).16 elderly were interviewed (aged between 80 and 93 years), residents in their home. The analysis of the interviews confirm that QoL is a multidimensional concept that encompasses several components of life. There were 7 shared themes, reflecting the experience of well-being in older people living at home. The dimensions are: living relationships that drive away loneliness, fill the time with activities that follow their own interests, accept themselves as elderly person, choose how and where to live, think about death.The results of the study show that older people perceive QOL as made of multiple components and variables. Elderly are focused on the remaining capacities, on the acceptance of the positive aspects of their lives rather than on what they can no longer do. This study help to identify some social and health strategies to guarantee the best way to live the last part of life.INTRODUZIONE. La qualità di vita (QoL) degli anziani è vulnerabile a causa del declino delle capacità fisiche e mentali, dell’uscita dal lavoro, della frantumazione della famiglia e dell’isola- mento. Molti strumenti che la rilevano sono costruiti per adulti: poche ricerche indagano come le persone anziane intendono la propria QOL. SCOPO. Questo studio ha l’obiettivo di esplorare e comprendere le percezioni delle persone anziane riguardo la QOL. METODO. È stata condotta una ricerca qualitativa, fenomenologico-ermeneutica. Le narra- zioni sono state analizzate attraverso il metodo fenomenologico-grounded (Mortari, 2007). RISULTATI. Sono stati intervistati 16 anziani (età compresa tra 80 e 93 anni), residenti a domicilio. L’analisi conferma che la QOL è un concetto multifattoriale e multidimensionale, che racchiude in sé diverse componenti della vita. Dalle interviste, sono emersi 7 temi condivisi e ricorrenti, che riflettono l’esperienza di benessere nelle persone anziane che vivono a domicilio. Le dimensioni emerse sono: vivere relazioni che allontanino la solitudine, occupare il tempo con attività che assecondano i propri interessi, accettarsi come persona anziana, poter scegliere come e dove vivere, riflettere sulla propria morte. CONCLUSIONI. I risultati dello studio mostrano che gli anziani percepiscono la QOL formata da più componenti e variabili. Gli anziani si focalizzano sulle capacità residue, sull’accettazione degli aspetti positivi della propria vita piuttosto che su quello che non riescono più a fare o che manca. Questo studio può aiutare ad individuare alcune strategie sociali e sanitarie da applicare per garantire agli anziani il modo migliore di vivere l’ultima parte della vita.

Validation of the Italian Clinical Learning Environment Instrument (SVIAT): study protocol.Nursing students obtain most of their university credits in internship environments whose quality can affect their clinical learning. Several tools are available to measure the quality of the clinical learning environment (CLE) as perceived by students: these instruments developed in other countries, were validated in Italian but do not discriminate those CLEs capable (or not) to promote significant clinical learning.To validate an instrument to measure the capability of the CLE to generate clinical learning; the secondary aim is to describe the learning environments as perceived by nursing students according to individual course site and tutorial models adopted.The study will be developed in three phases: a) instrument development and pilot phase, b) validation of the psychometric properties of the instrument and c) description of the CLEs as perceived by the students including factors/item confirmed in the validation process. Expected outcomes. A large validation, with more than 8,000 participating students is expected; the construct under lying will be confirmed through exploratory and confirmatory factor analysis and will report high internal consistency; the instrument will report also a high test-retest and inter-rater reliability; in addition, the instrument will demonstrate predictive ability by discriminating those units able (or not) to activate effective learning processes.

La enfermedad de von Willebrand tipo plaquetario (PT-VWD) y tipo 2B (2B-VWD) son trastornos hemorrágicos raros, caracterizados por agregación plaquetaria a bajas concentraciones de ristocetina (RIPA). El diagnóstico diferencial no es fácil y representa un desafío. Hasta el presente, sólo se habían reportado cinco mutaciones en el gen GP1BA relacionadas con este desorden. Describimos aquí la sexta mutación relacionada con PT-VWD, en un paciente con sintomatología hemorrágica severa, macro-trombocitopenia, leve agregación plaquetaria espontánea, RIPA positivo a 0,3 y 0,4 mg/mL, VWF:RCo/VWF:AgT en el nucleótido 3805 en el gen GP1BA del paciente, resultando en un cambio de Trp a Leu en el residuo 246 (p.W246L), en la región de la GPIBα que une al VWF. Esta mutación no se identificó en su madre ni en 100 controles sanos. Es considerada como dañina por análisis in sílico. Consideramos queesta sustitución es responsable del fenotipo PT-VWD del paciente. Dada la ausencia de la misma en los 100 normales estudiados, no se considera un polimorfismo. Fil: Woods, Adriana Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina Fil: Sánchez Luceros, Analía Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina. Academia Nacional de Medicina de Buenos Aires. Instituto de Investigaciones Hematológicas "Mariano R. Castex"; Argentina Fil: Bermejo, Emilse. Academia Nacional de Medicina de Buenos Aires. Instituto de Invest. Hematológicas "mariano R. Castex". Departamento de Hemostasia y Trombosis. Div.de Trombosis; Argentina Fil: Paiva Palomino, Juvenal Hernán. Academia Nacional de Medicina de Buenos Aires. Instituto de Invest. Hematológicas "mariano R. Castex". Departamento de Hemostasia y Trombosis. Div.de Trombosis; Argentina Fil: Alberto, Maria F.. Academia Nacional de Medicina de Buenos Aires. Instituto de Invest. Hematológicas "mariano R. Castex". Departamento de Hemostasia y Trombosis. Div.de Trombosis; Argentina Fil: Grosso, Silvia H. Academia Nacional de Medicina de Buenos Aires. Instituto de Invest. Hematológicas "mariano R. Castex". Departamento de Hemostasia y Trombosis. Div.de Trombosis; Argentina Fil: Kempfer, Ana Catalina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina. Academia Nacional de Medicina de Buenos Aires. Instituto de Investigaciones Hematológicas "Mariano R. Castex"; Argentina Fil: Lazzari, María Ángela. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina