Outcomes of Master\u27s Education in Nursing

This qualitative, descriptive study examined changes in perspective experienced by 22 recent graduates of Master’s in Nursing programs from three Ontario universities. Participants responded to semi-structured, taped interviews and recounted personal, practice, and attitudinal changes they could attribute to completing a Master’s program in Nursing. Among outcomes were personal ones including greater self-confidence, credibility, and acuity of critical thinking. Deeper and broader world-views of the profession and health care were evident. All participants valued evidence-based practice, reporting greater use of multiple information sources. Participants communicated with other professionals on more equal terms and some described a multicultural function, translating knowledge between staff nurses and members of other disciplines. Pride in nursing and its potential for shaping health care was a recurring theme. More professional opportunities became available following Master’s studies. The outcomes of this study contribute to understanding the effects of graduate education in nursing

The Process of Master’s Education in Nursing: Evolution or Revolution?

In this qualitative, descriptive study, the process of achieving change in knowledge and attitudes through Master’s education in nursing is examined. Twenty-two recent graduates from three Ontario universities participated in semi-structured, taped interviews. Participants recounted personal and professional changes they attributed to completing a Master’s program in Nursing and their experience of the process of change. After responding to questions about differences they perceived in themselves, participants reviewed Mezirow’s (1991; 1994) 11 stages of perspective transformation and discussed whether these phases resonated for them. Some felt that the stages described their experience accurately; others reported their experience of the process was not as dramatic as Mezirow’s description implied. Several who had taken degree completion baccalaureate programs perceived their baccalaureate experience to be more congruent with Mezirow’s transformation process than the change process in their Master’s program. At the Master’s level, the majority felt the changes were evolutionary, not revolutionary. Most reported that rather than undergoing a perspective transformation, they were building on values and attitudes from the baccalaureate level. This study contributes to understanding the processes of change experienced by students in graduate education in nursing

Nurses' Experiences of Distance Education Programmes

Aim.  This paper reports on a study exploring the experiences of nurses undertaking distance education (DE) programmes. Background.  While DE has many advantages in terms of the flexibility, autonomy and freedom that it affords to learners, the literature reports that students undertaking these programmes can also experience feelings of being disconnected and isolated. Methods.  A convenience sample of 15 participants was selected, and data were collected using in-depth interviews. Data were analysed using a qualitative design that drew most heavily on the methodological procedures of grounded theory. Findings.  Habermas’ theory of communicative action was found to be relevant to the interpretation of data and four categories were constructed to explain participants’ experiences in relation to DE, namely: lifeworld lamented; lifeworld experienced; lifeworld ceded and learning within a bounded system. These categories reflect the manner in which participants experienced the lifeworld component (the interactive and subjective dimensions) and the system component (objective and outcome oriented dimensions) of the educational realm. While data indicated diversity in how the boundedness of the programmes was experienced, overall such standardized, instrumental courses were viewed favourably by participants within the limitations of their own personal circumstances. Conclusion.  Distance education as a means of disseminating nursing knowledge should be strengthened. The challenge for nurse educators is to develop DE programmes that minimize their limitations and maximize their potential.AM

Upregulation of FcyRIIb on monocytes is necessary to promote the superagonist activity of TGN1412

The anti-CD28 superagonist antibody TGN1412 caused life-threatening cytokine release syndrome (CRS) in healthy volunteers, which had not been predicted by preclinical testing. T cells in fresh peripheral blood mononuclear cells (PBMCs) do not respond to soluble TGN1412 but do respond following high-density (HD) preculture. We show for the first time that this response is dependent on crystallizable fragment gamma receptor IIb (Fc?RIIb) expression on monocytes. This was unexpected because, unlike B cells, circulating monocytes express little or no Fc?RIIb. However, Fc?RIIb expression is logarithmically increased on monocytes during HD preculture, and this upregulation is necessary and sufficient to explain TGN1412 potency after HD preculture. B-cell Fc?RIIb expression is unchanged by HD preculture, but B cells can support TGN1412-mediated T-cell proliferation when added at a frequency higher than that in PBMCs. Although low-density (LD) precultured PBMCs do not respond to TGN1412, T cells from LD preculture are fully responsive when cocultured with Fc?RIIb-expressing monocytes from HD preculture, which shows that they are fully able to respond to TGN1412-mediated activation. Our novel findings demonstrate that cross-linking by Fc?RIIb is critical for the superagonist activity of TGN1412 after HD preculture, and this may contribute to CRS in humans because of the close association of Fc?RIIb-bearing cells with T cells in lymphoid tissues

Characterization of new human CD20 monoclonal antibodies with potent cytolytic activity against non-Hodgkin lymphomas

Despite the rapid and widespread integration of chimeric CD20 monoclonal antibody (mAb), rituximab, into the management of non-Hodgkin lymphoma, its efficacy remains variable and often modest when used as a single agent. To develop more potent reagents, human immunoglobulin transgenic mice were used to generate a panel of immunoglobulin G1kappa (IgG1kappa) CD20 mAbs. All reagents bound strongly to CD20(+) cells and recruited mononuclear cells for the lysis of malignant B cells. However, 2 mAbs, 2F2 and 7D8, were exceptionally active in complement-dependent cytotoxicity (CDC), being able to lyse a range of rituximab-resistant targets, such as CD20-low chronic lymphocytic leukemia (CLL), in the presence of human plasma or unfractionated blood. Further analysis showed that 2F2 and 7D8, like rituximab, redistributed CD20 into Triton X-100-insoluble regions of the plasma membrane, but that they had markedly slower off-rates. To determine whether off-rate influenced CDC, a non-complement activating F(ab')(2) antihuman kappa reagent was used. This reagent markedly slowed the off-rate of rituximab and increased its CDC activity to that of 2F2 and 7D8. Thus, with increasing evidence that mAb therapeutic activity in vivo depends on complement activation, these new CD20 reagents with their slow off-rates and increased potency in CDC hold considerable promise for improved clinical activity