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OBIETTIVO: Descrivere la soddisfazione lavorativa (job satisfaction) ed esplorare le motivazioni della richiesta di turnover da parte degli infermieri clinici. METODO: Studio mixed-method condotto presso un’Azienda Ospedaliera di Roma Hub di II livello, su un campionamento di convenienza al personale infermieristico in servizio nelle seguenti tre aree cliniche: medica, chirurgica e d’urgenza/emergenza. RISULTATI: Il campione di 133 infermieri risulta avere una buona job satisfaction (60,9%). Il 21% si ritiene insoddisfatto e il 18% è incerto sul grado di soddisfazione. Gli infermieri appartenenti all’aerea urgenza-emergenza sono quelli che mostrano una più alta soddisfazione (43,7%), mentre i più insoddisfatti sono gli appartenenti all’area chirurgica (53,3%). La fascia di età tra 45-50 anni è disposta al turnover immediato, rispetto agli over 50 che preferisce rimanere nella realtà ove opera. L’analisi qualitativa ha fatto emergere 7 macroaree. CONCLUSIONI: Gli infermieri riferiscono una ottimale soddisfazione lavorativa, ma molti di loro ritengono necessario un turnover. I risultati possono avere importanti implicazioni per gli infermieri per contribuire a migliorare gli ambienti di lavoro, al fine di limitare l’intenzione di turnover. AIM: To describe job satisfaction and to explore the rationale for the nurse turnover request. METHOD: A mix-method was carried out. The study was conducted in Hub Hospital in Rome, using a convenience sampling to all nursing staff on duty in the following areas: medical area, surgical and urgency/emergency areas. RESULTS: The sample of 133 nurses was found to have good job satisfaction (60.9%). 21% feel dissatisfied and 18% are uncertain about the degree of satisfaction. Nurses belonging to the urgent-emergency area showed the highest satisfaction (43.7%), while the most dissatisfied were nurses of the surgical area (53.3%). The age group between 45-50 years is useful for immediate turnover, compared to the over 50 who prefer to remain in the reality where it operates. The qualitative analysis revealed 7 macro-areas. CONCLUSIONS: Nurses have good job satisfaction, but many of them believe a turnover is necessary. The findings have important implications for nurses by helping to improve work environments, thus reducing turnover intention.

Cord blood (CB) is a valuable source of stem cells. Most CB units are still cryopreserved in single bags in the world's CB banks. Thawing a single CB unit, dividing it into two parts, expanding the smaller one and refreezing the other would optimize ex vivo expansion of CB progenitors prior to transplantation: expanded and unexpanded cells could be infused together to accelerate early engraftment.The feasibility of refreezing CB samples was investigated by evaluating the effect of 3 successive cryopreservation procedures in 9 CB units. The number and viability of WBC, BFU-E, CFU-GM, CFU-MIX, LTC-IC, and the absolute CD34+ cell count were assessed at time 0 and after each thawing. The percentage of CD34 cells expressing CD38, L-selectin, VLA-4, VLA-5, H-CAM, LFA-1 and CXCR4 was also evaluated.After three freezing and thawing procedures, WBC counts decreased, while lymphocytes were unchanged. Viability was 90% of basal values after the first thawing and did not change. BFU-E decreased significantly only after the third thawing. CFU-GM and CFU-MIX did not change significantly, nor did LTC-IC, CD34+ cell counts and CAM and CXCR4 expression on CD34+/ CD38-- cells.These data show that two successive freeze-thaw procedures do not significantly affect the clonogenic potential and CAM expression of cord blood progenitors. This information could be exploited to devise new options in ex vivo expansion procedures and quality controls prior to transplantation.

Between February 1995 and August 1997, 11 children (eight males, three females) aged 4-16 years (median 7 years) underwent allogeneic PBPC transplantation for treatment of hematological disorders. Seven patients with acute leukemia (n = 5 ALL, n = 1 AML) or lymphoma (n = 1) received primary allogeneic PBPC transplantation, four patients received a second allotransplantation for graft failure (n = 1 AML, n = 1 sickle cell anemia) or disease recurrence (n = 1 ALL, n = 1 MDS). Five donors were HLA-identical siblings, five were 0-1 antigen mismatched family members and one was a matched unrelated donor. Donors received G-CSF 10-12 microg/kg/day for 3-7 days, and underwent one or two leukaphereses. The median cell yield per donor expressed per kg of recipient body weight was as follows: mononucleated cells 10.8 x 10(8)/kg (range 4.7-21.2); CD34+ cells 8.6 x 10(6)/kg (range 3.2-22); CD3+ cells 3.7 x 10(8)/kg (range 2.7-7.5). All patients achieved an ANC0.5 x 10(9)/l after a median of 12 days (11-18). An unsupported platelet count50 x 10(9)/l was reached 15 days (13-21) after PBPC transplantation; four patients failed to reach this threshold. Acute GVHD (aGVHD) grades II to IV occurred in eight (73%) patients: seven of them experienced grade III-IV aGVHD. Seven patients evaluable for chronic GVHD (cGVHD) were scored as absent in five, limited in one and extensive in one patient. As of September 1997, six patients (55 %) were alive between 60 and 938 days post-transplant (median follow-up 274 days); four patients with malignancy were alive in CR after primary allotransplantation, two patients were alive after a second PBPC transplant. Five patients have died with the main causes of death being aGVHD (n = 3), ARDS (n = 1), relapse of the underlying disease (n = 1). In conclusion, despite the limited number of patients, these preliminary results indicate that PBPC may be considered as an alternative to bone marrow for allografting also in children.