Health concerns regarding malnutrition among the older populations: considerations from a Slovenian perspective.

Diet is an important factor in a healthy lifestyle for all age groups. However, with aging it is important to be aware that the diet, due to changed physiology, needs an accordingly adjusted and balanced daily regime. This article reviews the field of older population's nutrition and presents: the most common nutritional disorders, causes, demographics and malnutrition measurement tools. Relevant scientific literature as well as professional Slovenian papers were identified through specific searches with topic-related keywords in EBSCO, PubMed, Web of Science and COBISS databases. The results of the identified papers are subsequently discussed in a descriptive narrative. The reviewed literature shows noticeable trends of high proportions of malnutrition among older persons, both globally and in Slovenia: predominantly observed are overnutrition like overweight and obese, but as well, and often unnoticed, undernutrition. The latter is more worrying, as inadequate knowledge in health care institutions regarding nutritional screening tools and measures to prevent drastic forms of undernutrition, seem to facilitate these trends. Though there are many reasons for insufficient food intake in older people, the article formulates considerations that can feed appropriate education and awareness programs, and through correct screening point to timely identification of malnourished individuals and those with risk of malnutrition. The promotion and implementation of such considerations could prevent malnutrition among the older population, reduce the frequency of nutritional disorders and co-morbidities, and generally improve the nutritional status of the older population, thus, provide better quality of health later in life.

Diet is an important factor in a healthy lifestyle for all age groups. However, with aging it is important to be aware that the diet, due to changed physiology, needs an accordingly adjusted and balanced daily regime. This article reviews the field of older population's nutrition and presents: the most common nutritional disorders and causes with the limited demographics of malnutrition among the older populations, and several efficient malnutrition measurement tools. The global literature shows noticeable trends of high proportions of malnutrition among older persons, both globally and in Slovenia. Predominantly observed are overnutrition like overweight and obese, but as well, and often unnoticed, undernutrition. The latter is more worrying, as inadequate knowledge in health care institutions regarding nutritional screening tools and measures to prevent drastic forms of undernutrition, seem to facilitate these trends. The article formulates considerations to be implemented in appropriate education and awareness programs, to reduce the frequency of nutritional disorders and co-morbidities, and generally improve the nutritional status of the older population, thus, provide better quality of health later in life.

Developing a Universal Nursing Competencies Framework for Registered Nurses: A Mixed-Methods Approach.

PURPOSE: To develop a methodology for identifying the universal nursing competencies required for registered nurses (RNs). DESIGN: A mixed-methods approach was used. METHODS: The research in this article entails a combination of different methodological approaches, namely the Delphi technique and an empirical quantitative nonexperimental study. A total of 14 experts with credentials in the nursing field participated in the former. Consensus was defined as at least 80% agreement. Subsequently, a purposive sample of 321 RNs participated in the empirical quantitative nonexperimental study. The data were collected during 2014. FINDINGS: In the study's first stage, 39 professional nursing competencies were identified using the Delphi technique. In the second stage, factor analysis resulted in seven factors: professional nursing clinical practice; professional communication and quality in nursing; determinants of health and safety in nursing; critical thinking and self-planning of professional work; new knowledge and knowledge transfer in nursing; management and coordination in nursing; and nursing research. Together they explain 74.9% of the variance. CONCLUSIONS AND CLINICAL RELEVANCE: In the future, the identification of the national nursing competencies should be considered. The study has some limitations; however, the proposed methodology revealed in this study may be the first step in overcoming them.

Identification of nursing competency assessment tools as possibility of their use in nursing education in Slovenia---a systematic literature review.

AIMS: The aim of this study was to identify existing tools that purport to measure clinical nursing competence through the use of a systematic literature review to consider the possibilities of using them in nursing education in Slovenia. DESIGN: A systematic literature review following PRISMA guidelines. METHODS: The databases that were searched included MEDLINE, Cinahl, Cochrane Library and Science Direct. The search was limited to available full text articles in English, published between 2003 and 2013. RESULTS: After applying the inclusion and exclusion criteria, seven papers were included. The review indicated the availability of some highly reliable tools that enable assessment of clinical competences in nursing education. At the same time, however, it is still not clear as to what competences nursing students must achieve during their education. CONCLUSIONS: Our review showed that various tools exist for assessing clinical nursing competences. In addition, for each country it is important to compose an assessment tool, which measures actual clinical nursing competences, and means customized for their needs and based on their national guidelines. Slovenia has three academic faculties and five colleges with a nursing education program. Common standards regarding assessment of nursing competences among them would definitely lead to better practices and success of graduates and subsequently for the professionals in nursing field. What emerges from the literature is the need to move forward, to foster creativity, freedom of thought and originality and for these reasons we have to consider the possibility of developing a model for obtaining universal clinical competencies.

Students' well-being in nursing undergraduate education.

BACKGROUND: Although previously the Job-Demand-Control-Support model has been successfully applied in many studies in the field of health care and education, the model was never used for the evaluation of the nursing students' well-being. OBJECTIVES: The aim of this study was to promote nursing students' well-being. The objective was to verify whether the Job-Demand-Control-Support model is appropriate for the evaluation of their well-being. DESIGN: The Job-Demand-Control-Support model was implemented and investigated in a multiple-case study, which consisted of two phases. In phase I the students' well-being along with the perceived levels of control, support, and demand for each individual student during their study were identified. These results were used in phase II, where the usefulness of the presented model was evaluated. SETTINGS: The study was performed at the end of the academic year 2009/2010 in two institutions: Tampere University of Applied Sciences, School of Health Care, Finland (institution 1); and the University of Primorska, Faculty of Health Sciences, Slovenia (institution 2). PARTICIPANTS: Participants of the study were nursing graduates who finished their studies in 2009/2010 and the Vice-Deans for education of both institutions. The final sample included 83 students in institution 1 and 79 students in institution 2. METHODS: The case study was combined with a survey (phase I) and an interview (phase II). RESULTS: Although the students' well-being in these two institutions was different, most students of both institutions perceived their studies as low strain, placid, and only some of the students in both institutions had a high risk of malaise. The Vice-Deans for education of both institutions confirmed that the application of the Job-Demand-Control-Support model provided relevant information on the nursing students' well-being, which helped in planning improved nursing study programmes. CONCLUSIONS: This study demonstrated that the Job-Demand-Control-Support model is appropriate for estimating undergraduate nursing students' well-being.

The effect of voluntariness on the acceptance of e-learning by nursing students.

Although e-learning is an innovation that is worth making generally available, it is not always accepted by nursing students. Many researchers state that voluntariness is closely related to the individual level of adoption of innovations. Hence, we hypothesized that voluntariness moderates the effect of perceived attributes of innovations (e.g. relative advantage, compatibility, complexity, trialability, and observability), which determines the acceptance of e-learning. To test the hypothesis a survey involving two groups of nursing students was carried out. For the first group the usage of e-learning was mandatory, for the second group it was optional. The results confirm our hypothesis. Institutions, interested in e-learning initiatives, should consider the effect of voluntariness when implementing e-learning. This paper provides a useful reference that can help e-learning providers to develop guidelines that can improve the acceptance of e-learning.

Hyperhomocysteinemia and the role of B vitamins in cancer.

BACKGROUND: Patients suffering from malignancies have increased complications due to corresponding cardiovascular diseases and risk factor for the development of venous thromboembolism. Epidemiological studies have shown that increased homocysteine plasma concentration (hyperhomocysteinemia) is related to a higher risk of coronary heart disease, stroke, peripheral vascular disease and malignancies. Homocysteine (tHcy) is an intermediate sulfur-containing amino acid produced from methionine during processing of dietary proteins. The plasma homocysteine levels are strongly influenced by diet, as well as by genetic factors. Folic acid, vitamins B6 and B12 are dietary components which influence the plasma homocysteine levels the most. Several studies have found that high blood levels of B vitamins are related to the integrity and function of DNA, and, are at least related to lower concentration of homocysteine. Folate depletion has been found to change DNA methylation and DNA synthesis in both animal and human studies. Because of this critical role of folate, most studies including homocysteine have focused on these two actions. CONCLUSIONS: Hyperhomocysteinemia proves to be the most common condition highly associated with both venous and arterial thrombosis in many cancer patients, while the associated pathophysiology has not been precisely established yet. Therefore, of current interest is the possible role of folate metabolism developing into a cancer initiating hyperhomocysteinemia. This review will discuss this possibility.

Comparison of bacterial and phage display peptide libraries in search of target-binding motif.

Genetic engineering allows modification of bacterial and bacteriophage genes, which code for surface proteins, enabling display of random peptides on the surface of these microbial vectors. Biologic peptide libraries thus formed are used for high-throughput screening of clones bearing peptides with high affinity for target proteins. There are reports of many successful affinity selections performed with phage display libraries and substantially fewer cases describing the use of bacterial display systems. In theory, bacterial display has some advantages over phage display, but the two systems have never been experimentally compared. We tested both techniques in selecting streptavidin-binding peptides from two commercially available libraries. Under similar conditions, selection of phage-displayed peptides to model protein streptavidin proved convincingly better.