Violenza domestica: quali competenze e conoscenze dell’infermiere in emergenza?

Il fenomeno della violenza domestica e le condotte di approccio a questo problema assumono una particolare rilevanza sia sociale che sanitaria. Lo scopo della ricerca è quello di misurare le conoscenze e le competenze degli infermieri che prestano servizio nelle realtà operative di ED (Emergenza Dipartimento) rispetto alla gestione in urgenza della donna che ha subito violenza domestica. E’ stato effettuato uno studio osservazionale trasversale che ha coinvolto gli infermieri del servizio di emergenza intraospedaliera (EDI) e Extraospedaliera (EDE) in tre ambiti territoriali afferenti ad una Azienda Sanitaria del nord Italia. Il campione è di tipo non probabilistico. Il questionario scelto è stato Help– Knowledge and Attitudes of Gender – Based Violence. Si evidenzia un risultato con un range di risposte corrette che vanno dal 72,6% al 99%. La comparazione fra gli infermieri dell’EDE e quelli dell’EDI ha evidenziato una maggiore comprensione del fenomeno dell’IPV (Intimate Partner Violence) da parte di questi ultimi; ciò con molta probabilità può essere dovuto, da un lato, al fatto che i secondi possiedono più strumenti e tempo per riconoscere i segni di maltrattamento, mentre la donna, dall’altro, ha la possibilità di ricercare maggiore empatia, un sostegno psicologico e una guida ai servizi che possano aiutare la propria famiglia. Le correlazioni provano, inoltre, una notevole sensibilità che il personale di ED ha sulle diverse tipologie di maltrattamenti, non solo fisiche, ma anche psicologiche, economiche e sessuali. Con molta probabilità tali conoscenze sono legate all’esperienza sul campo in quanto il 56,6% (n=56) del campione ha un’anzianità di servizio che va dagli 11 ai 30 anni. Le phénomène de la violence conjugale et les différentes approches à ce problème sont particulièrement importants sur les plans social et sanitaire. Le but de cette recherche est d’évaluer les compétences et les connaissances des infirmiers travaillant aux services d’urgence (ED) et qui assurent la prise en charge des femmes victimes de violence conjugale. Une étude par observation a été menée impliquant les infirmiers des services d’urgence intrahospitaliers (EDI) et extrahospitaliers (EDE) de trois territoires liés à une unité de soins du nord de l’Italie. Il s’agissait d’un échantillon non probabiliste et le questionnaire choisi était le Help–Knowledge and Attitudes of Gender–Based Violence. Le résultat a été globalement positif et les réponses correctes allait de 72,6 % à 99 % selon les questions. La comparaison entre infirmiers de l’EDE et de l’EDI a montré que ces derniers ont une meilleure connaissance du phénomène de la violence d’un partenaire intime (IPV – Intimate Partner Violence) par rapport aux premiers. Cela est peut-être dû au fait que, d’un côté, les infirmiers EDI ont davantage d’outils et de temps pour reconnaître les signes d’abus, tandis que la femme, de l’autre, a la possibilité de recevoir davantage d’empathie, un soutien psychologique et un guide aux services du territoire pour aider sa famille. En outre, les corrélations démontrent que le personnel ED est très conscient des différentes formes de maltraitance, qui ne concernent pas seulement le cadre physique, mais aussi les domaines psychologiques, économiques et sexuels. Il est fort probable que ces connaissances soient liées à leur expérience car 56,6 % des personnes interrogées travaillent dans ce secteur depuis au moins 11 ans. The phenomenon of domestic violence and the different approaches to this are especially important both from a social and health point of view. The aim of the survey is to measure the skills and knowledge of the nurses who work in Emergency Departments providing medical care to women who are victims of domestic violence. An observational study was implemented involving the nurses of the Intra-hospital Emergency Services (EDI) and of the Extra-hospital Emergency Services (EDE) of three territories linked to a Northern Italian healthcare unit. The sample is a non-probabilistic one. The title of the administered questionnaire is Help-Knowledge and Attitudes of Gender–Based Violence. There was a positive result overall with a range of correct answers ranging from 72.6% to 99% depending on the question. The comparison between EDE and EDI nurses showed a better understanding of the IPV phenomenon (Intimate Partner Violence) amongst the latter. This may be due to the fact, on the one hand, that EDI nurses have more tools and time in order to recognize the signs of abuse, while women, using the other services, have the possibility to get more empathy and psychological support along with information about assistance provided by territorial services available for families. Correlations demonstrate, moreover, that EDI staff have a strong awareness of the various kinds of abuse, not only physical but also psychological, economical and sexual ones. This particular knowledge is most likely linked to their experience because 56.6% of respondents have been working in this field for 11 to 30 years

Pancreatic cancer patient survival correlates with DNA methylation of pancreas development genes.

DNA methylation is an epigenetic mark associated with regulation of transcription and genome structure. These markers have been investigated in a variety of cancer settings for their utility in differentiating normal tissue from tumor tissue. Here, we examine the direct correlation between DNA methylation and patient survival. We find that changes in the DNA methylation of key pancreatic developmental genes are strongly associated with patient survival

L'apprendimento clinico in simulazione: studio osservazionale sulla soddisfazione percepita dagli studenti di infermieristica [Learning in clinical simulation: observational study on satisfaction perceived by students of nursing]

Introduzione: la simulazione nel contesto del laboratorio didattico sta divenendo un’importante metodologia di apprendimento, in quanto consente di riprodurre situazioni clinicoassistenziali realistiche. Tali attività formative professionalizzanti favoriscono lo sviluppo di abilità cognitive, affettive e psicomotorie in un contesto pedagogico sicuro e privo di rischi, ma richiedono di essere valutate con strumenti validi e affidabili. Obiettivo: indagare il grado di soddisfazione degli studenti di un Corso di Laurea in Infermieristica del nord Italia riguardo le esercitazioni con simulatori statici e ad alta fedeltà e i casi clinici. Metodo: è stato condotto uno studio osservazionale prospettico che ha coinvolto un campione non probabilistico di 51 studenti del terzo anno durante tutto l'a.a. 2013/14. Lo strumento di raccolta dati si compone dei 3 questionari Student Satisfaction and Self-confidence in Learning Scale, Educational Practices Questionnaire, Simulation Design Scale e di 3 domande sulla soddisfazione complessiva. L'analisi statistica è stata condotta con i programmi SPSS vers. demo. ed Excel di Office 2003. Risultati e Conclusioni: il tasso di risposta ottenuto è dell’89,5%. L’Alfa di Cronbach, ha evidenziato un’affidabilità interna ottima ( = .982). Gli studenti sono stati complessivamente soddisfatti delle attività svolte nel laboratorio didattico, dimostrando più entusiasmo per la simulazione con i manichini statici (71%) e con i simulatori ad alta fedeltà (60%), attività per le quali hanno avvertito un significativo coinvolgimento e apprendimento attivo. La didattica con i casi clinici ha ottenuto un grado di soddisfazione minore (38%) e per questo metodo si è riscontrato il maggior numero di elementi di debolezza. Parole chiave: studenti infermieri, simulazione, strategia di apprendimento attivo, simulatori ad alta fedeltà, soddisfazioneINTRODUCTION: Simulation in the context of the educational workshop is becoming an important learning method, as it allows to play realistic clinical-care situations. These vocational training activities promote the development of cognitive, affective and psychomotor skills in a pedagogical context safe and risk-free, but need to be accounted for using by valid and reliable instruments. AIM: To inspect the level of satisfaction of the students of a Degree in Nursing in northern Italy about static and high-fidelity exercises with simulators and clinical cases. METHODS: A prospective observational study has been conducted involving a non-probabili- stic sample of 51 third-year students throughout the academic year 2013/14. The data collection instrument consists of three questionnaires Student Satisfaction and Self-confidence in Learning Scale, Educational Practices Questionnaire, Simulation Design Scale and 3 questions on overall satisfaction. Statistical analysis was performed with SPSS 20.0 and Office 2003 Excel. RESULT AND CONCLUSION: The response rate of 89.5% is obtained. The Cronbach Alfa showed a good internal reliability (α = .982). The students were generally satisfied with the activities carried out in the teaching laboratory, showing more enthusiasm for the simulation with static mannequins (71%) and with high-fidelity simulators (60%), activities for which they have experienced a significant involvement and active learning. The teaching with clinical cases scored a lesser degree of satisfaction (38%) and for this method it was found the largest number of elements of weakness

CLL Exosomes Modulate the Transcriptome and Behaviour of Recipient Stromal Cells and Are Selectively Enriched in miR-202-3p

Bi-directional communication with the microenvironment is essential for homing and survival of cancer cells with implications for disease biology and behaviour. In chronic lymphocytic leukemia (CLL), the role of the microenvironment on malignant cell behaviour is well described. However, how CLL cells engage and recruit nurturing cells is poorly characterised. Here we demonstrate that CLL cells secrete exosomes that are nanovesicles originating from the fusion of multivesicular bodies with the plasma membrane, to shuttle proteins, lipids, microRNAs (miR) and mRNAs to recipient cells. We characterise and confirm the size (50-100 nm) and identity of the CLL-derived exosomes by Electron microscopy (EM), Atomic force microscopy (AFM), flow cytometry and western blotting using both exosome- and CLL-specific markers. Incubation of CLL-exosomes, derived either from cell culture supernatants or from patient plasma, with human stromal cells shows that they are readily taken up into endosomes, and induce expression of genes such as c-fos and ATM as well as enhance proliferation of recipient HS-5 cells. Furthermore, we show that CLL exosomes encapsulate abundant small RNAs and are enriched in certain miRs and specifically hsa-miR-202-3p. We suggest that such specific packaging of miR-202-3p into exosomes results in enhanced expression of 'suppressor of fused' (Sufu), a Hedgehog (Hh) signalling intermediate, in the parental CLL cells. Thus, our data show that CLL cells secrete exosomes that alter the transcriptome and behaviour of recipient cells. Such communication with microenvironment is likely to have an important role in CLL disease biology

Epigenetic changes mediated by polycomb repressive complex 2 and E2a are associated with drug resistance in a mouse model of lymphoma

Background: The genetic origins of chemotherapy resistance are well established; however the role of epigenetics in drug resistance is less well understood To investigate mechanisms of drug resistance we performed systematic genetic epigenetic and transcriptomic analyses of an alkylating agent-sensitive murine lymphoma cell line and a series of resistant lines derived by drug dose escalation   Methods: Dose escalation of the alkylating agent mafosfamide was used to create a series of increasingly drugresistant mouse Burkitt's lymphoma cell lines Whole genome sequencing DNA microarrays reduced representation bisulfite sequencing and chromatin immunoprecipitation sequencing were used to identify alterations in DNA sequence mRNA expression CpG methylation and H3K27me3 occupancy respectively that were associated with increased resistance   Results: Our data suggest that acquired resistance cannot be explained by genetic alterations Based on integration of transcriptional profiles with transcription factor binding data we hypothesize that resistance is driven by epigenetic plasticity We observed that the resistant cells had H3K27me3 and DNA methylation profiles distinct from those of the parental lines Moreover we observed DNA methylation changes in the promoters of genes regulated by E2a and members of the polycomb repressor complex 2 (PRC2) and differentially expressed genes were enriched for targets of E2a The integrative analysis considering H3K27me3 further supported a role for PRC2 in mediating resistance By integrating our results with data from the Immunological Genome Project (Immgenorg) we showed that these transcriptional changes track the B-cell maturation axis   Conclusions: Our data suggest a novel mechanism of drug resistance in which E2a and PRC2 drive changes in the B-cell epigenome; these alterations attenuate alkylating agent treatment-induced apoptosi

Victims’ experiences of learner challenging behaviour in primary schools in Phoenix, South Africa

Victims’ experiences of learner challenging behaviour in South African primary schools are an ongoing problem that is cause for concern, where additionally, the parents of the perpetrators are unapologetic, and defending their wrongdoing. In this scenario, there is little teachers can do to address ill-disciplined learners. In effect, teacher helplessness has further intensified the problem in primary schools. To establish the way in which the victims experience challenging behaviour, face-to-face semi-structured interviews were conducted with a sample of six learners (N = 6). Results indicate that the victims continuously suffer at the hands, and indeed the feet, of violent learners. Furthermore, as their cries go unheard, the problem remains persistent. Since schools have been failing to respond effectively to learner challenging behaviour, this article recommends immediate intervention by the Department of Basic Education (DBE) to offer a more constructive solution to this problem, one that will effect change and offer relief and protection to the victims. The article concludes that victims continue to suffer, with little or no safeguarding from teachers. Future research ought to include the role of teachers in safeguarding learners against learner victimisation and challenging behaviour in primary schools.Keywords: behaviour; experiences; fear; impact; learner wellbeing; primary schools; victim

Tingkat Kesulitan dan Daya Beda Butir Soal Ujian Akhir Semester Matakuliah Penelitian Pendidikan

Penelitian ini bertujuan untuk tingkat kesulitan dan daya beda butir soal ujian akhir semester mata kuliah Penelitian Pendidikan. Penelitian menggunakan pendekatan kuantitatif dengan jenis penelitian deskriptif. Penelitian dilakukan pada mahasiswa PJKR IKIP Budi Utomo angkatan 2020 sebanyak 40 mahasiswa. Instrumen penelitian yang digunakan berupa tes dengan bentuk soal tes pilihan ganda sebanyak 50 butir soal. Penelitian yang telah dilakukan, menunjukkan sebanyak 29 butir soal atau sebanyak 58% butir soal dinyatakan valid dan sebanyak 21 butir soal atau sebanyak 42% butir soal dinyatakan tidak valid dengan kriteria sangat reliabel. Tingkat kesulitan butir soal termasuk dalam kategori kurang baik karena komposisi soal tidak berimbang yang dimana butir soal yang masuk kategori mudah sebanyak 24%, kategori sedang sebanyak 52% dan kategori sulit sebanyak 0%. Daya beda butir soal 46% masuk kategori sangat baik, 18% masuk dalam kategori baik, 2% masuk kategori sedang, dan 34% masuk kategori tidak baik

Pengaruh Olahraga Elektronik terhadap Prestasi Belajar Siswa

The emergence of electronic sports provides opportunities for all levels of society to participate in competitive sports. Apart from that, electronic sports also have a negative impact on children's growth and development which, if not properly handled, will have an impact on students' learning achievements. The aim of this research is to determine the effect of electronic sports on student learning outcomes. The research method is comparative research with a quantitative approach. The research sample was 20 class VII students and 20 class VIII students. The instruments used in this research were questionnaires and documents. Data analysis was carried out using a simple regression test. The research results found that electronic sports had a negative influence on student learning outcomes. The research conclusion is that electronic sports have a negative impact on children's development if done excessively, especially learning outcomes

Kelayakan Buku Ajar Mata Kuliah Belajar dan Pembelajaran Berbantuan Modular Object Oriented Dynamic Learning Environment (MOODLE))

The purpose of this research is to determine the feasibility of textbooks based on the Modular Object Oriented Dynamic Learning Environment (MOODLE) at the virtual personal server (VPS) address: http://103.247.11.240. The research method used is descriptive quantitative research methods. The data collection instruments used questionnaires and observations. Furthermore, descriptive data analysis was carried out. Success is measured using a content activity design standard. Feasibility is reviewed from technical standards, content standards and visual content standards. The technical standard scored 82.5% in the very feasible category. Content and content standards scored 82% in the very feasible category and visual design standards scored 77.32% with the feasible category