A pilot study of the use of the oral and faecal microbiota for the diagnosis of ulcerative colitis and Crohn's disease in a paediatric population.

Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect the gastrointestinal tract. Changes in the microbiome and its interaction with the immune system are thought to play a key role in their development. The aim of this study was to determine whether metagenomic analysis is a feasible non-invasive diagnostic tool for IBD in paediatric patients. A pilot study of oral and faecal microbiota was proposed with 36 paediatric patients divided in three cohorts [12 with CD, 12 with UC and 12 healthy controls (HC)] with 6 months of follow-up. Finally, 30 participants were included: 13 with CD, 11 with UC and 8 HC (6 dropped out during follow-up). Despite the small size of the study population, a differential pattern of microbial biodiversity was observed between IBD patients and the control group. Twenty-one bacterial species were selected in function of their discriminant accuracy, forming three sets of potential markers of IBD. Although IBD diagnosis requires comprehensive medical evaluation, the findings of this study show that faecal metagenomics or a reduced set of bacterial markers could be useful as a non-invasive tool for an easier and earlier diagnosis.

Fostering leadership competence and satisfaction in nursing undergraduates through a student-led conference: A quasi-experimental pre-post study.

BACKGROUND: Numerous benefits have been reported for student-led conferences, such as increased leadership. This competence has been recognized as important for nurses so as to ensure the provision of safe and high-quality care in complex environments. However, research has yet to examine empirically the impact of student-led conferences on students' leadership behaviours. OBJECTIVES: To examine the impact that participation in a student-led conference had on the self-perceived leadership competence of nursing undergraduates. DESIGN: Quasi-experimental single group pre-post intervention study. SETTING: Faculty of Medicine and Health Sciences at the Universitat Internacional de Catalunya. PARTICIPANTS: 31 students enrolled in two elective modules offered during the final year (fourth year) of a nursing degree programme. METHODS: Pre-post assessment of self-perceived leadership behaviours among nursing students involved in planning and organizing a scientific conference. In addition to carrying out the tasks of organizing the Conference, all students participated as co-authors of an oral communication, thus being able to develop both cognitive and non-cognitive domains. Leadership was measured using ES_SALI scale, the Spanish version of the Self-Assessment Leadership Instrument. RESULTS: Involvement in the student-led conference led to a statistically significant increase in self-perceived leadership competence among nursing undergraduates (p < .001). Both the total ES_SALI score and scores on each of its four dimensions (Strategic thinking, Emotional intelligence, Impact and influence, and Teamwork skills) increased significantly, and the percentage change was above 8% in all cases (p < .01). The greatest increase (10.99%) corresponded to the 'Impact and influence' dimension of leadership. CONCLUSIONS: The results suggest that student-led conferences are an effective way of helping nursing undergraduates to develop their leadership competence.

Daily intake of probiotic strain Bacillus subtilis DE111 supports a healthy microbiome in children attending day-care.

There is ample evidence suggesting that modulations in gut microbiota play an important role in inflammation and immunity. In particular, the microbiota of children is highly susceptible to environment influences, such as infections. Consequently, probiotics and their ability to promote and support a healthy microbiome have been increasingly studied. This study aimed at investigating the effects of a probiotic supplement (Bacillus subtilis DE111) on the microbiome composition of preschool aged children attending day care. Healthy children aged 2-6 years old were randomised to receive either probiotic or placebo once a day for 8 weeks. No significant changes of the overall microbiome equilibrium were seen in between the two groups or from baseline to week 8. However, alpha diversity was increased in the probiotic group from baseline to week 8 (P<0.05), with no change in the placebo group. A decrease in the Firmicutes/Bacteroidetes ratio following probiotic supplementation (P<0.05) was also observed. Differential abundance analysis revealed an increase in Alistepes (P<0.01), Bacteroides (P<0.05), Parabacteroides (P<0.01), Odoribacter (P<0.001) and Rikenellaceae (P<0.001) in the probiotic group, most of which are involved in inflammation reduction. In addition, a decrease in Eisenbergiella (P<0.001), Lactobacillales (P<0.01) and Streptococcaceae (P<0.01), which is considered pro-inflammatory, were also observed in the probiotic group. Together with a reduction of the F/B ratio observed in the probiotic group, these results suggest probiotic supplementation with Bacillus subtilis DE111 introduce subtle but positive changes in the microbiome of children aged 2-6 years old.

Assessing the competences associated with a nursing Bachelor thesis by means of rubrics.

BACKGROUND: Writing a Bachelor thesis is the last step in obtaining a university degree. The thesis may be job- or research-orientated, but it must demonstrate certain degree-level competences. Rubrics are a useful way of unifying the assessment criteria. OBJECTIVES: To design a system of rubrics for assessing the competences associated with the Bachelor thesis of a nursing degree, to examine the system's reliability and validity and to analyse results in relation to the final thesis mark. DESIGN: Cross-sectional and psychometric study conducted between 2012 and 2014. SETTINGS: Nursing degree at a Spanish university. PARTICIPANTS: Twelve tutors who designed the system of rubrics. Students (n = 76) who wrote their Bachelor thesis during the 2013-2014 academic year. METHODS: After deciding which aspects would be assessed, who would assess them and when, the tutors developed seven rubrics (drafting process, assessment of the written thesis by the supervisor and by a panel, student self-assessment, peer assessment, tutor evaluation of the peer assessment and panel assessment of the viva). We analysed the reliability (inter-rater and internal consistency) and validity (convergent and discriminant) of the rubrics, and also the relationship between the competences assessed and the final thesis mark. RESULTS: All the rubrics had internal consistency coefficients >0.80. The rubric for oral communication skills (viva) yielded inter-rater reliability of 0.95. Factor analysis indicated a unidimensional structure for all but one of the rubrics, the exception being the rubric for peer assessment, which had a two-factor structure. The main competences associated with a good quality Bachelor thesis were written communication skills and the ability to work independently. CONCLUSION: The assessment system based on seven rubrics is shown to be valid and reliable. Writing a Bachelor thesis requires a range of degree-level competences and it offers nursing students the opportunity to develop their evidence-based practice skills.

Salud Pública y Genética. Nuevos retos para el profesional de enfermería / Public health and genetics. New challenges for nursing professionals

El proyecto Genoma Humano (HGP) iniciado en 1990 está aportando importantes conocimientos sobre el mapa genético humano. Para poder estar a la altura de estos avances científicos los profesionales de la salud han de tener la formación en genética necesaria a fin de brindar unos cuidados integrales de salud. En Estados Unidos, la Universidad ha incluido en el currículo de Enfermería la genética como parte integral de la formación de sus profesionales, permitiendo que el rol de la enfermera haya adquirido una identidad propia como enfermeras genetistas. En Europa, Inglaterra es el país que contempla de una manera más realista y actual la necesidad de formación de profesionales de la salud expertos en consejo genético, y sus políticas sanitarias están orientadas a paliar esta necesidad. En España, sin embargo, esta formación es insuficiente y las reformas de los nuevos planes de estudios para la convergencia europea (Bolonia 2010) tienen que permitir incorporar contenidos en genética que preparen a las enfermeras de atención primaria para abordar estos temas de manera eficaz y saber dirigir, como expertas en el cuidado integral de la salud, a los individuos y sus familias hacia la prevención

The Human Genoma Project (GHP) that started in 1990 is bringing forward relevant knowledge about the human genetic map. In order to be on a par with the recent scientific advances the health professionals should have the appropriate genetic training in order to provide a comprehensive health care. In the United States, some Universities have included the subject of Genetics in the Nursing curriculum as part of the essential program in the educational training of the health professionals. By doing so, it allows the nursing role to have its own identity as Genetic Counsellor. In Europe, the United Kingdom is the country that considers in a more realistic and updated way the need of an educational training in genetic counselling for their health experts and their health policies are being orientated to cover these needs. In Spain, however, this educational training is not enough. The reforms of the new contents of the nursing studies carried out in the European convergence (Bologna 2010) should allow to incorporate genetics studies in order to prepare primary care nurses to address this issues in an effective way. As experts in comprehensive health care they should be able to take care of the individuals and their families in prevention

Computed tomography in partial carpal arthrodesis.

We carried out X-rays and computed tomography in 59 wrists in patients who had previous surgical intercarpal fusions. 1.2 mm thick axial images were obtained perpendicular to the axis of the joint. CT showed whether or not the carpal fusions were united. Compared with CT, plain radiography yielded a 25% false negative and 6% false positive rate. We conclude that CT is more useful than plain X-rays for evaluating partial carpal arthrodesis.

[Left aorto-ventricular tunnel. Diagnosis with transthoracic and transesophageal echo-Doppler]. / Túnel aorto-ventricular izquierdo. Diagnóstico mediante eco-Doppler transtorácica y transesofágica.

Aortic-left ventricular tunnel is an infrequent congenital heart lesion consisting of an abnormal tubular-shaped communication between the aortic root and the left ventricle that bypasses the aortic valve. It is clinically undistinguishable from aortic insufficiency. Its prompt and precise diagnosis is crucial since early surgical treatment is definitely indicated, in contrast to aortic insufficiency. In our case, two-dimensional and pulsed color-flow Doppler imaging established the diagnosis, and the transesophageal approach was a great aid in detecting the aortic opening with its turbulent diastolic flow, and in tracing its intramyocardial course. This paper may be of interest not just as a new case-report but insofar as it stresses how importantly the transthoracic and transesophageal echocardiographic and Doppler scanning contributes to its diagnosis and therapeutic indication.

Carbamazepine: an alternative drug for the treatment of nonhereditary chorea.

Five patients with a moderate to severe degree of nonhereditary chorea were successfully treated with standard anticonvulsant doses of carbamazepine. In two cases, the cause of chorea was related to a streptococcal infection. In another patient, the involuntary movements appeared seven days after severe head injury. The cause in the remaining two patients could not be determined with certainty, despite extensive laboratory investigations. Improvement began within four to 15 days after the initiation of therapy. No side effects were noticed in four patients throughout treatment (3 months to 36 months). In one patient, the medication had to be discontinued after 17 days, because of an allergic cutaneous rash. In view of our results, we propose that carbamazepine be considered as an alternative drug for the treatment of nonhereditary chorea.

[Pneumococci resistant to penicillin]. / Neumococos resistentes a la penicilina.

Between January of 1983 and December 1984, 11 strains of pneumococci resistant to penicillin were isolated, from a total of 46 strains studied with clinical signification, thus accounting for 23.9%. In nine cases (19.5%) pneumococci showed partial resistance to penicillin and in two strains (4.3%) resistance was total. Pneumococcal disease in our 11 patients was demonstrated by blood culture in 7 cases and by culture of the CSF, in 4. Diagnosis of the patients were as follows: 4 sepsis in immunosuppressed host, 2 bacteremia without an evident focus, 1 pneumonia, 3 meningitis and 1 ventriculitis. Vancomycin and rifampin are the most active in this cases. Some of the new cephalosporins of the third generation (cefotaxime and ceftriaxone) and cefuroxime have a good activity in vitro and a good passage to the CSF.