International study on nurses' views and experiences of compassion.

BACKGROUND: Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. AIM: The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. METHODS: An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. RESULTS: The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. CONCLUSION: Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. LIMITATIONS: Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. IMPLICATIONS FOR NURSING POLICY: Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

Juvenile gigantomastia in a 12-year-old girl: a case report.

Juvenile gigantomastia is a rare, massive breast enlargement. It appears in adolescence and can affect one or both breasts of otherwise healthy girls. This report describes a case of a bilateral and symmetric gigantomastia in a 12-year-old girl.

Quality of life and smoking among industrial workers in Greece.

BACKGROUND: Smoking is a predictor of quality of life, while socio-economic factors influence the prevalence of smoking habits. Occupational medical research has been fairly late in coming to study quality of life aspects in working populations. OBJECTIVES: The aim of the study is the assessment of smoking prevalence among blue- and white-collar workers industrial workers in Greece and its impact on health-related quality of life. METHODS: In a cross-sectional study the Euro-Qol 5D questionnaire was been used in a random sample of 472 blue and white-collar heavy industry workers. RESULTS: 57% of the study population were current smokers. The difference in prevalence of smoking across all the examined socio-demographic variables (sex, age, education and occupation) was not statistically significant. Smoking had a significant impact on the health-related quality of life. Smokers recorded significant lower scores (74.9) in the overall Visual Analogue Scale in comparison with non-smokers (79.1), (p = 0.007). Further analysis revealed that age, smoking and education were significant predictors of VAS score. A non-significant contribution was found for occupation and sex. Smokers reported significantly higher rates of problems regarding mobility, self-care and anxiety/depression than non-smokers. Logistic regression analysis showed an independent impact of smoking on mobility, self-care and anxiety/depression level. CONCLUSIONS: Smoking is a significant hazard and a strong predictor of poor quality of life among the blue- and white-collar workers under study. Anti-smoking policies integrated into a broader context of occupational health and safety at work could reduce smoking rates and thus improve worker's quality of life.

Neuropsychologic impairment after coronary bypass surgery: effect of gaseous microemboli during perfusionist interventions.

OBJECTIVE: Neuropsychologic impairment is a common complication of coronary bypass surgery. Cerebral microemboli during cardiopulmonary bypass are the principal cause of cognitive deficits after coronary bypass grafting. We have previously demonstrated that the majority of cerebral emboli occur during perfusionist interventions (ie, during the injection of air into the venous side of the cardiopulmonary bypass circuit). The purpose of this study was to determine whether an increase in perfusionist interventions is associated with an increased risk of postoperative cognitive impairment. METHODS: Patients undergoing elective coronary artery bypass grafting (n = 83) underwent a battery of neuropsychologic tests preoperatively and 3 months postoperatively. Patients were divided into 2 groups according to the median value of perfusionist interventions during cardiopulmonary bypass. Group 1 patients (n = 42) had fewer than 10 perfusionist interventions, and group 2 patients (n = 41) had 10 or more interventions. RESULTS: The 2 groups of patients were similar for all preoperative, intraoperative, and postoperative variables, with the exception of longer cardiopulmonary bypass times in group 2 patients (P <.001). Group 2 patients had lower mean scores on 9 of 10 neuropsychologic tests, with 3 (Rey Auditory Verbal Learning, Digit Span, and Visual Span) being statistically significant. Group 2 patients had worse cognitive test scores, even when controlling for increased bypass times. Group 2 patients had a nonsignificant trend toward an increased prevalence of neuropsychologic impairment 3 months postoperatively. CONCLUSIONS: Introduction of air into the cardiopulmonary bypass circuit by perfusionists, resulting in cerebral microembolization, may contribute to postoperative cognitive impairment.

Management of neglected giant omphalocele with Gore-tex in a child aged 8 years.

Omphalocele is a disease of neonatal age and its present management is successful in almost all specialized centers of Pediatric Surgery. A case of an 8-year-old girl who was managed with conservative treatment during her neonatal period with mercurochrome (Grob method) is presented. Due to very serious congenital cardiopathy, a corrective operative procedure of the omphalocele was not feasible during neonatal age. However, following successful heart surgery the child grew up with her initial disorder. The child was first seen in our clinic at the age of 5 years, presenting with a very large omphalocele. Following a staged pressure of the abdomen with a special belt an attempt was made to close the ventral hernia successfully using a Gore-tex sheet.

Androgen resistance due to mutation of the androgen receptor.

The androgen receptor (AR) is a 'one-stop' signal transduction system that is the core of the intracellular androgen-response apparatus. It is an androgen-regulated, DNA-binding protein that regulates the expression of certain target genes, primarily at the transcriptional level. Mutations at the X-linked AR locus cause deficient or defective AR activity and, thereby, an extraordinarily wide spectrum of clinical androgen resistance. At one extreme, the affected 46,XY person is an infertile phenotypic female; at the other, he is a phenotypic male who may even be fertile, yet have gynecomastia or other focal signs of postpubertal subvirilization. We have identified 32 proven or putatively pathogenic alterations in the AR gene of 38 androgen-resistant families. This permits heterozygote detection and prenatal diagnosis whenever relevant. Most of the mutations affect the AR's androgen-binding domain, partly because our search has been targetted on those whose genital skin fibroblasts have impaired androgen-binding activities. The AR is a prototypic member of a subfamily that includes the receptors for progesterone, glucocorticoid, and mineralocorticoid. Observations that correlate AR genotype with clinical and receptor phenotypes of androgen resistance will help to generate a fine structure-function map of the AR and its close relatives. Constitutional variation in androgen sensitivity, that may be restricted to an organ (or organ system), could contribute to the pathogenesis of certain diseases whose sex ratio departs significantly from one.