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Background. Academic failure can negatively impact on the student, the university and the nursing workforce in the short term. The aim of this study is to analyze the characteristics and predictors of academic success in two cohorts of students of a Nursing Bachelor’s Degree program. Methods. This longitudinal study enrolled students who attended the Nursing Bachelor’s Degree program. The Tor Vergata University includes 21 Nursing Bachelor’s Degree programs at several Sanitary Institutions of the Rome area, with a mean annual recruitment of 800 students. We considered two cohorts of students beginning the program in the 2011-2012 and 2012-2013 academic years, respectively. The follow-up of these two cohorts ended in the 2017-2018 academic year. We considered socio-demographic and academic variables in the nursing field (pre-admission test grade, training exam grade in the first, second and third year and professional license exam grade). The outcome variable is academic success defined as graduation on time; academic failure is defined as changing degree, delay in completion of the course, attrition and dismissal (failure to complete the studies). Data were collected at baseline (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3) of the course. A logistic regression was performed to identify predictors of academic success. Results. 2,041 students were enrolled, with an average age of 22.0 years (± 4.6, 18-50); 67.4% were female. Regarding academic success, 30.6% of students graduated on time and so achieved academic success, while 69.4% failed to complete the course within the established time: 5.4% (110/2,041) changed the course, the attrition rate was 7.3%, 0.3% (6/2,041) overdue from the course for expiring of the terms, 18.0% (368/2,041) is attending the course and 38.4% (784/2,041) graduated after more than three years. Pre-admission test grade (OR: 10.0, 95% CI: 10.020-10.054) and training exam grade at the second and third years (OR: 10.0 95% CI: 10.027-10.139; OR: 10.2 95% CI: 10.171-10.294) predicted academic success. Discussion and Conclusions. Some nursing students changed course during the last year of the program, while the training exam grade of the second and third years had predicted academic success; this is a brand new information derived from this study. In addition, we confirmed the association of age, gender, secondary school type and grade and preadmission test with academic success. For these reasons, clinical training should be improved and the quality of internship wards, as learning environments, should be monitored. Italian universities should undertake establishing the ideal cut-off in pre-admission tests to determine which students have a high probability of academic success. [ABSTRACT FROM AUTHOR]

Background: Moral Distress (MD) is a unique form of distress that occurs when people believe they know the ethically correct action to take but are constrained from doing so. Limited clinical experience and insufficient ethical knowledge contribute to nursing students' MD, which can potentially cause negative outcomes. The aims of this study are: (1) to describe the MD intensity of nursing students, and (2) to analyze differences and associations between MD intensity and socio-demographic and academic variables., Methods: A cross-sectional study design with a convenience sample of the second, third, and delayed graduation students was included; only students willing to participate and who had attended their scheduled internships in the last six months were eligible for inclusion. To measure the level of MD, we used the It-ESMEE. We collected socio-demographic and academic variables. The data collection occurred from January 2024 to March 2024., Results: The students who adhered to the collection were N = 344. The findings reveal that the students perceived a high level of MD in situations related to clinical internship and class. They perceived higher levels of MD when nursing was not their first career choice, were separated or divorced, did not have children, and were not an employed student. The overall MD score is statistically significantly lower among students who had nursing as their first career choice (β = -0.267, p < 0.05), have children (β = -0.470, p < 0.01), and are employed (β = -0.417, p < 0.01). In contrast, being separated or divorced (β = 0.274, p < 0.01) was associated with a higher MD score., Conclusions: This study has some limitations: data reflect a local context, and the findings may not be generalizable to other regions or educational environments. Additionally, students' recollections of their experiences could be influenced by the passage of time, and there may be a selection bias since only students willing to participate were included. The findings suggest that nursing education programs should incorporate more robust training in ethical decision-making and stress management to better prepare students for the moral challenges in their professional practice.

Background: Family and Community Health Nurses (FCHNs) are at a higher risk of experiencing emotional exhaustion and feelings of low personal accomplishment. Higher levels of professional identity may decrease these negative feelings. Its measurement could produce positive effects for FCHNs and the quality of care they offer., Aim: This study aims to evaluate the psychometric properties (validity and reliability) of the Nurses Professional Values Scale-Revised (NPVS-R) on FCHNs in Italy., Research Design: A cross-sectional research design was used., Participants and Research Context: A convenience sample of FCHNs was recruited in an out-of-hospital setting from Italy. A total of 202 nurses were eligible (mean age of 41.11 ± 10.55 years; 78.2% female)., Ethical Considerations: The study was performed in accordance with the World Medical Association Declaration of Helsinki. Participants were asked for their consent and were guaranteed anonymity in the information collected. The study was approved by the internal review board of the university., Results: Confirmatory Factor Analysis (CFA) supported a unidimensional factorial structure of the NPVS-R with an adequate fit to the data. Internal consistency reliability was also supported. The construct validity was further reinforced by the concurrent validity results showing a positive and significant correlation of professional identity with job satisfaction., Conclusion: The NPVS-R is a valid and reliable instrument to measure professional identity among FCHNs. It can be used in clinical practice to improve FCHNs' psychological-emotional feelings and quality of care provided, in research to allow comprehensive understanding of professional identity, and in educational settings to monitor the professional identity levels of Family and Community Health Nursing students., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Fournier's gangrene (FG) is a rare form of necrotizing fasciitis of the perineal, genital, or perianal region. It is characterized by an aggressive course and high mortality rate, over 20%. FG demands immediate treatment including resuscitation maneuvers, intravenous antibiotic therapy and early surgical debridement. Background/Objectives : The gold-standard treatment for FG is surgical reconstruction. However, up to date, no precise guidelines exist. Thus, we decided to systematically review the literature, focusing on FG contemporary approaches to reconstructive surgery, aiming to analyze the various reconstructive strategies and their specific indications. Methods : A systematic review was carried out according to the PRISMA statement by searching various databases from April 2014 to April 2024, using the terms ''Fournier Gangrene OR Fournier Gangrene Reconstruction OR Fournier Gangrene Treatment OR Fournier Gangrene Plastic Surgery OR Necrotizing Fasciitis OR Necrotizing Fasciitis AND Reconstruction". The eligibility criteria included original studies aimed at discussing FG reconstruction with at least three clinical cases. Results : The final synthesis included 38 articles, and 576 reconstructions were described. Of these, 77.6% were minimally invasive strategies (direct closure, secondary healing, grafts, and local random flaps), while more invasive reconstructions (loco-regional flaps based on known vascular anatomy) were adopted in 22.4%. No free flaps were reported. Conclusions : FG requires immediate medical interventions including broad-spectrum antibiotic therapy, surgical debridement, adjuvant therapies, and reconstructive surgeries. Taking into account the anatomical characteristics of the inguinal-crural region, skin grafts and local random flaps could offer versatile and effective reconstructions for most FG cases, while the more invasive strategies should be reserved for very few cases. Future research is warranted to define an FG dedicated reconstruction protocol.

During the twenty-first century, engineered nanomaterials (ENMs) have attracted rising interest, globally revolutionizing all industrial sectors. The expanding world population and the implementation of new global policies are increasingly pushing society toward a bioeconomy, focused on fostering the adoption of bio-based nanomaterials that are functional, cost-effective, and potentially secure to be implied in different areas, the medical field included. This research was focused on silica nanoparticles (SiO 2 -NPs) of bio-based and synthetic origin. SiO 2 -NPs are composed of silicon dioxide, the most abundant compound on Earth. Due to their characteristics and biocompatibility, they are widely used in many applications, including the food industry, synthetic processes, medical diagnosis, and drug delivery. Using zebrafish embryos as in vivo models, we evaluated the effects of amorphous silica bio-based NPs from rice husk (SiO 2 -RHSK NPs) compared to commercial hydrophilic fumed silica NPs (SiO 2 -Aerosil200). We evaluated the outcomes of embryo exposure to both nanoparticles (NPs) at the histochemical and molecular levels to assess their safety profile, including developmental toxicity, neurotoxicity, and pro-inflammatory potential. The results showed differences between the two silica NPs, highlighting that bio-based SiO 2 -RHSK NPs do not significantly affect neutrophils, macrophages, or other innate immune system cells.

Introduction: The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research., Methods and Analysis: This scoping review will be conducted following Arksey and O'Malley's framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit., Ethics and Dissemination: This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals., Registration Details: The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: This research aims to explore the perceptions of nursing students and directors of bachelor of nursing degree courses regarding reasons for attrition amongst nursing students., Methods: A qualitative descriptive study was conducted using inductive thematic analysis. The study included a purposeful sample of 12 students and 4 directors of bachelor of nursing degree courses., Results: As reasons for attrition, the directors highlighted a lack of preparation for nursing studies and students' limited awareness of possibilities for support and learning. The students emphasized insufficient support from academic staff and poor course organization. Economic and family issues and a misunderstanding of the professional role of a nurse were cited as reasons by both directors and students., Conclusions: The findings provide important insight into attrition in the nursing programme. Further research is warranted, particularly in other contexts. Addressing student attrition requires a comprehensive approach that includes the provision of adequate support systems, mentorship, and resources for students., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Objectives: To assess the prevalence of US-confirmed enthesitis in a cohort of patients with SLE and to analyse the clinical associations to enthesitis during the course of SLE., Methods: In a retrospective analysis of the SLE cohort of the Lupus Unit of the Careggi University Hospital, US examinations of SLE patients presenting with tender and/or swollen joints were retrieved to assess the presence of enthesitis. Patients with US-proven enthesitis were compared with SLE controls with tender and/or swollen joints who showed no US evidence of enthesitis. Clinical and laboratory features were compared at disease onset and during follow-up., Results: A total of 400 patients fulfilling EULAR/ACR classification criteria for SLE were assessed. Of these, 106 underwent articular US examination. Evidence of enthesitis was found in 31/106 (29.2%) patients. Seventy-one patients without US-enthesitis were included as controls; four were excluded due to lack of follow-up data. Laboratory and clinical features were comparable between cases and controls at disease onset. Throughout a median follow-up of 10.0 (interquartile range [IQR] 8.3-23.3) years for cases and 12.4 (IQR 7.2-13.3) years for controls, patients with enthesitis were less likely to develop renal involvement (22.6% vs 46.5%, P = 0.028) and failed B cell depletion more frequently (75.0% vs 0%)., Conclusion: In SLE patients with clinically active joints, US-proven enthesitis is a fairly common finding. Enthesitis in SLE could be the hallmark of a distinct disease phenotype with less renal involvement, more arthritis and low response to anti-CD 20 therapy, potentially requiring a tailored treatment., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

For decades, scholars have studied leader-member exchange (LMX) relationships to understand and explain the effects of leadership on follower attitudes and performance outcomes within work settings. One available instrument to measure these aspects is the LMX-7 scale. This measurement has been widely used in empirical studies, but its psychometric properties have been poorly explored. The aim of this study was to test the psychometric characteristics (content, structural and construct validity, and reliability) of the Italian version of the LMX-7 scale and to support its cultural adaptation. We used a cross-sectional multi-center design. The forward-backward translation process was used to develop the Italian version of the scale. The scale was administered through an online survey to 837 nurses and nurse managers working in different settings. The factorial structure was tested using both exploratory and confirmatory factor analyses (EFA and CFA), and reliability was evaluated using Cronbach's alpha. For the construct validity, we used hypothesis testing and differentiation by known groups. The Italian version of the LMX-7 scale presented one dimension. All the psychometric tests performed confirmed its validity and suggested its usefulness for future research.

Aim: To test the mediating role of burnout in the relationship between self-efficacy and academic success in nursing students., Design: This was a cross-sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students., Methods: We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018-2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self-Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed., Results: The participants (n = 556) had a median age of 20 years (IQR 19-22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self-efficacy on academic success and also a significant indirect effect of this relationship via burnout., Conclusion: The mechanism by which self-efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification., Impact: Nurses' professors should be engaged in strategies to promote self-efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse., (© 2022 John Wiley & Sons Ltd.)

Student academic satisfaction is one of the most important factors affecting the success and quality of a higher education institute and is an indicator about teaching and learning. This study aims to summarize and critically evaluate the instruments assessing academic satisfaction in nursing education. A systematic review was undertaken, PRISMA were used for the screening of studies. MEDLINE, Cochrane, Scopus and CINAHL were searched using MeSH terms; seven eligible articles were identified referring to five assessment tools. COSMIN was used for evaluation of the methodological of the instruments. The systematic review identified five satisfaction measurement tools used in nursing education. The analysis of the instruments rarely considered a confirmative validity structure, measurement error or criterion validity. The best available instrument was the Nursing Students Satisfaction Scale (NSSS) for validation methodology; however, it needs further validation studies that consider CFA, reliability, criteria validity, hypothesis testing and measurement error., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Academic failure can negatively impact on the student, the university and the nursing workforce in the short term. The aim of this study is to analyze the characteristics and predictors of academic success in two cohorts of students of a Nursing Bachelor's Degree program., Methods: This longitudinal study enrolled students who attended the Nursing Bachelor's Degree program. The Tor Vergata University includes 21 Nursing Bachelor's Degree programs at several Sanitary Institutions of the Rome area, with a mean annual recruitment of 800 students. We considered two cohorts of students beginning the program in the 2011-2012 and 2012-2013 academic years, respectively. The follow-up of these two cohorts ended in the 2017-2018 academic year. We considered socio-demographic and academic variables in the nursing field (pre-admission test grade, training exam grade in the first, second and third year and professional license exam grade). The outcome variable is academic success defined as gradua-tion on time; academic failure is defined as changing degree, delay in completion of the course, attrition and dismissal (failure to complete the studies). Data were collected at baseline (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3) of the course. A logistic regression was performed to identify predictors of academic success., Results: 2,041 students were enrolled, with an average age of 22.0 years (± 4.6, 18-50); 67.4% were female. Regarding academic success, 30.6% of students graduated on time and so achieved academic success, while 69.4% failed to complete the course within the established time: 5.4% (110/2,041) changed the course, the attrition rate was 7.3%, 0.3% (6/2,041) overdue from the course for expiring of the terms, 18.0% (368/2,041) is attending the course and 38.4% (784/2,041) graduated after more than three years. Pre-admission test grade (OR: 10.0, 95% CI: 10.020-10.054) and training exam grade at the second and third years (OR: 10.0 95% CI: 10.027-10.139; OR: 10.2 95% CI: 10.171-10.294) predicted academic success., Discussion and Conclusions: Some nursing students changed course during the last year of the program, while the training exam grade of the second and third years had predicted academic success; this is a brand new information derived from this study. In addition, we confirmed the association of age, gender, secondary school type and grade and preadmission test with academic success. For these reasons, clinical training should be improved and the quality of internship wards, as learning environments, should be monitored. Italian universities should undertake establishing the ideal cut-off in pre-admission tests to determine which students have a high probability of academic success.

Background: Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students., Aim: This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the exams necessary to progress to the next level)., Research Design: The study used a cross-sectional research design., Participants and Research Context: Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy., Ethical Considerations: The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent., Results: The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753-0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate., Discussion: The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students., Conclusion: This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.

It has been suggested that the Theory of Mind (ToM) may rely on more basic processes of social cognition, such as action control (e.g., joint action), even if little is known about this relationship. The relationship between ToM and joint action can be studied in patients with Parkinson's disease (PD), because they are characterized not only by a deficit in ToM (and in its cognitive and affective subcomponents) but also by a deficit in the inhibition of competing responses. Sixty PD patients and 60 matched healthy controls (HCs) performed a go/no-go Flanker task in both joint and individual conditions. Cognitive (Advanced Test or AT) and affective (Emotion Attribution Task or EAT) ToM also were measured. Thirty-five PD patients and matched HCs also performed the standard Flanker task, as a control measure. In patients, only individuals with high AT scores exhibited a joint Flanker effect, whereas in HCs the joint effect was found irrespectively of AT score. Patients with low EAT scores showed a greater interference effect than patients with high scores, whereas the opposite pattern was found for HCs. In regression analysis AT and EAT scores predicted the Flanker effect in the joint condition only. In the standard task, both groups showed a Flanker effect. The role of different fronto-striatal circuits, especially in PD patients, could explain the different involvement of cognitive and affective ToM in joint tasks. The Flanker effect is discussed considering the referential coding account and the attention-focus account as possible candidates to explain joint action effects.

The antitumor activity shown by many platinum complexes has produced a strong interest in research of new organometallic compounds having anticancer action. Among the many metal compounds synthesized and tested, those based on titanium have received considerable attention because of their cytotoxic activity against solid tumors. Particularly, new titanocene compounds containing aromatic groups linked to the Cp (cyclopentadienyl ring, C5H5) have been synthetized, such as the titanocene Y (bis-[(p-methoxybenzyl)cyclopentadienyl]titanium dichloride) that displayed promising medium-high cytotoxic activity on breast cancer cell lines. Other titanocene complexes recently synthesized, obtained by replacing the substituent methoxy-aryl of cyclopentadienes of titanocene Y with ethenyl-methoxide or ethenyl-phenoxide, showed increased cytotoxic activity on breast cancer cell lines being more stable compounds. In this paper, we report that new titanocene complexes holding lipophilic groups, for instance a methyl group on benzyl carbon, exhibit improved antiproliferative effect on breast cancer cell line MCF-7. Similar results have been obtained introducing a 5-methoxy naphthyl group to further stabilize the titanocene complexes. These inhibitory effects on breast cancer cells have been ascribed to human topoisomerase I and II inhibition as demonstrated by specific enzymatic assays., (Copyright © 2015 Elsevier Ltd. All rights reserved.)