What does professionalism look like? Attitudes and behaviours derived from a Delphi study.

In 2010, the chief nursing officer and nurse director for Wales commissioned a study to identify attitudes and behaviours associated with professionalism for nurses and midwives in Wales. The study was part of an exploration project of professionalism in nursing and midwifery. A Delphi study design was used to generate a consensus on the question 'What does "professionalism" mean in terms of attitudes and behaviours for nurses and midwives in Wales?' The question was put to an expert panel, comprising 27 members of the Consultant Nurse, Midwives and Health Professionals Forum and eight directors of nursing, using electronic questionnaires. The descriptors generated were subsumed into categories that were ranked, statistically tested and attributed a Likert-type score before consensus was achieved. The resultant categories and themes defined acceptable and unacceptable attitudes and behaviours, and enabled the development of an overarching short definition of professionalism. This carves a unique niche in the evidence base on professionalism and provides a tool for replicating the study in other countries and for other professional groups such as healthcare support workers, nursing and midwifery students and allied health professionals.

Dose-Dependent Alterations to In Vitro Human Microbiota Composition and Butyrate Inhibition by a Supercritical Carbon Dioxide Hops Extract.

Hop cones (Humulus lupulus L.) have been used throughout history as an additive in beer brewing and as herbal supplements with medicinal and culinary properties. The objective of this study was to ascertain the effect of a range of concentrations of a supercritical CO2 extract of hops on the composition and metabolism of human gut bacterial communities using in vitro batch culture systems. Fermentations were conducted over 24 h using a mixed human fecal inoculum. Microbial metabolism was assessed by measuring organic acid production and microbial community alterations were determined by 16S rRNA gene sequencing. Butyrate, an important short chain fatty acid in maintaining colonic well-being, decreased at elevated concentrations of hops, which may partly be accounted for by the concomitant reduction of Eubacterium and Coprococcus, known butyrate-producing genera, and also the inhibition of Bifidobacterium, a beneficial organism that has a butyrogenic effect through metabolic cross-feeding with intestinal commensals. The hops compounds also caused dose-dependent increases in the potentially pathogenic Enterobacteriaceae and potentially beneficial Akkermansia. Thus, hops compounds had a significant impact on the structure of the bacterial consortium, which warrants further study including human clinical trials.

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Frequency of insomnia report in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS).

BACKGROUND AND PURPOSE: Insomnia and Obstructive Sleep Apnoea Hypopnea Syndrome (OSAHS) are the two most common sleep disorders, and both have significant associated health costs. Despite this, relatively little is known about the prevalence or impact of insomnia in those with OSAHS, although a recent study suggested there may be substantial comorbidity between these disorders [Chest 120 (2001) 1923-9]. The primary aim of this study was to further explore the prevalence of insomnia in OSAHS. A secondary aim was to assess the effect of factors that may impact on both conditions, including mood and sleep-beliefs. PATIENTS AND METHODS: Consecutive patients referred to an accredited Sleep Investigations Unit [n = 105] completed a brief standardized battery of validated questionnaires assessing sleep-related variables and mood. RESULTS: Results showed a high rate of prevalence of clinical insomnia in this OSAHS population, and a strong positive correlation between OSAHS and insomnia symptom severity. Further, OSAHS patients with comorbid insomnia had increased levels of depression, anxiety and stress compared to patients with OSAHS-only, and both patient groups reported similar and significant levels of dysfunctional beliefs about sleep. Findings in relation to habitual sleep, assessed using subjective (diary) and objective criteria (polysomnogram), were mixed but generally showed greater sleep disturbance among those with OSAHS-insomnia compared to those with OSAHS-only. CONCLUSIONS: Overall these findings suggest that comorbidity of insomnia in OSAHS patients may lead to increased OSAHS severity and that patients with both conditions may experience more symptoms relating to depression, anxiety and stress. These findings underscore the need for insomnia assessment and management services, even in clinics that primarily service patients with OSAHS.