Development and implementation of the Bachelor of Nursing (Conversion) course in Vanuatu.

CONTEXT: Vanuatu, a Pacific Island nation in the Western Pacific region, has to date educated its nurses by diploma program. Research evidence in developed countries has consistently shown that nurses educated by bachelor degree improve patient health outcomes and reduce hospital length of stay. In seeking to improve health outcomes, the Vanuatu Ministry of Health decided to introduce a new Bachelor of Nursing degree to provide a skilled, safe nursing workforce for the provision of health care to its peoples{1-3}. The curriculum for this degree was to be developed by Ni-Vanuatu nurse educators with the collaboration of educators from the WHO Collaborating Centre, University of Technology Sydney. However, it was first necessary to upgrade (from diploma to bachelor level) the qualifications of teachers and senior nursing practitioners who would lead the new degree course by introducing a Bachelor of Nursing (Conversion) course. ISSUES: In order to design and implement a Bachelor of Nursing (Conversion) course that would be relevant for the educational and healthcare context in Vanuatu and that would meet qualification requirements of the local regulatory bodies, it was essential to build collaborative relationships with key stakeholders in Vanuatu. A second key concern was to design a program that would cater for participants who were working full time, who were not all living in the same physical location, and who had limited access to internet technology and resources. The course also needed to take into account that participants were multilingual, and that English was not their first language. LESSONS LEARNED: Lessons learned included the importance of coming to understand the sociocultural nexus within which this course was developed and implemented, as well as appreciating the constraints that affect nursing education within the Pacific

Assessing and developing students' English language proficiency prior to clinical placements: a pilot study

As universities cater for increasing numbers of students from linguistically diverse backgrounds, there is a need to develop effective post-enrolment spo- ken language assessment and development programs to ensure students have adequate English language levels for clinical placements. This paper presents an evaluation of a pilot project that embedded a clinical communication strat- egy into the first year of a nursing degree to ensure students had a level of English language considered safe for clinical placement. The strategy con- sisted of an initial language screening task to identify students in need of de- velopment, a follow-up compulsory language program for those identified, and a post program language assessment task, in which students needed to achieve a threshold level, in order to proceed to clinical placements. The study was conducted in a large metropolitan university in Australia. Data collected included pre- and post-assessment results, survey data on students’ evalua- tions, and student results from two clinical placements following the commu- nication strategy. Descriptive statistics and thematic analysis were used to an- alyse data. The study found: the communication strategy was effective in iden- tifying students in need of language development; the majority of students improved their communication skills during the language development pro- gram; and the threshold level of language used to determine whether students were ready to proceed to clinical placement seemed appropriate. The study suggests that combining initial and post-assessment with an intervention, all of which are systemically integrated into a degree program, results in a strat- egy with high educational impact

An adaptable, sustainable and inclusive institution-wide model for embedding academic language and literacies

Widening participation and internationalisation of the higher education sector have led to a more diverse student population across Australian universities; this includes domestic and international students who do not have sufficient English language proficiency (e.g., Murray, 2016), and thus, need developmental support to meet the academic language and literacy demands of their studies (e.g., O’Loughlin & Arkoudis, 2009). The institution-wide four-stage Embedding English Language Framework has been implemented at University of Technology Sydney since 2019: screening of all commencing students; mandatory discipline/subject-aligned language development programs for those identified as requiring support; milestone tasks to evaluate language development; and further milestone tasks at various points in degree programs (Edwards et al., 2021). It has proven to be adaptable throughout the disruptive global pandemic as any of the four stages can be realised in a face-to-face/online/hybrid context; it is sustainable as the teaching and learning, and assessment of communication is embedded in all core discipline subjects throughout a degree program, as supported by university-wide policies and practices (Arkoudis & Kelly, 2016; Fenton-Smith & Humphreys, 2015; Wingate, 2015); and it is inclusive as any onshore/offshore student who needs additional language support is accommodated in the framework, to help enhance their self-confidence, sense of belonging, motivation and autonomy – all key ingredients to their wellbeing, success and retention (Lantolf & Swain, 2019). Results from an ongoing evaluation show that the framework is making a positive impact on students’ sense of belonging and confidence, intercultural communication, and overall academic participation and engagement

Factores de riesgo asociados a la emergencia hipertensiva, en pacientes debutantes y con diagnóstico de hipertensión arterial crónica atendidos en el servicio de medicina interna y sala de emergencias del Hospital Regional Escuela Asunción Juigalpa durante el periodo de enero-noviembre 2018

FUNDAMENTO: La Hipertensión Arterial es una de las enfermedades crónicas no transmisibles más frecuentes, su expresión más grave clínicamente es la emergencia hipertensiva que mata a millones de personas cada año en el mundo, los factores de riesgo relacionados al desarrollo de esta patología son muy variados, desde la genética hasta el desarrollo de hábitos que interfieran con la aparición brusca de una emergencia hipertensiva. Las emergencias hipertensivas constituyen una problemática a nivel nacional ya que genera gastos económicos al sector salud y daños irreversibles a los organismos de los pacientes que la desarrollan, prevenir estos eventos es uno de los principales retos del médico en su día a día, el objetivo de este estudio es identificar factores de riesgo que se vean relacionados con el desarrollo de una emergencia hipertensiva, si bien estos factores de riesgos ya están determinados en la hipertensión arterial, estudiar su comportamiento epidemiológico en el Hospital Regional Escuela Asunción Juigalpa es muy importante. OBJETIVO: Evaluar los factores de riesgo asociado a la emergencia hipertensiva, en pacientes debutantes y con diagnóstico de hipertensión arterial crónica atendidos en el Hospital Regional Escuela Asunción Juigalpa en el período de enero-noviembre 2018. MATERIAL Y MÉTODO: El tipo de estudio es ‘‘Descriptivo-prospectivo de corte transversal” Descriptivo porque se observa y describe los factores de riesgo así como las complicaciones de la problemática. Retrospectivo dado a que se toma información de pacientes que fueron atendidos en fechas ya pasadas. De corte transversal porque se miden los factores de riesgo y complicaciones en una población específica y en un periodo de tiempo delimitado. La muestra total la constituyeron 40 pacientes que asistieron a las salas de Emergencia y Unidad de Cuidados Intensivos del Hospital, las cuales presentaron daño a órgano diana relacionado a la hipertensión arterial. EL instrumento utilizado fue una ficha de recolección de datos donde se reflejan el resultado de lo obtenido en los expedientes clínicos. RESULTADOS: En los resultados obtenidos se identificó que la mayoría de pacientes tenían mayor de 45 años, en relación al sexo predominaron los de sexo femenino con un 62,5%, en cuanto a la ocupación se obtuvo que la mayoría eran ama de casa en un 57,7%,s y que el 100% de los pacientes no realizaba ninguna actividad física. El tiempo de evolución de la hipertensión arterial fue el 70% de 2-10 años y la creatinina estaba alterada en un 47.5%. Se encontró que el 22.5% consumían alcohol y el 77.5% no fumaba tabaco. Al examinar los medicamentos extra hospitalario se encontró que el 47,5% utilizaba un antihipertensivo y que el 10% si había presentado una crisis hipertensiva anteriormente, en cuanto a las emergencias hipertensivas se encontró que el 42,5% presentaron cardiopatía isquémica y que el 50% de los pacientes egresaron muertos. CONCLUSIÓN: Al analizar los datos obtenidos de los expedientes se encontró que los pacientes que desarrollaron una emergencia hipertensiva estaban en los rangos de la tercera de edad, no realizaban actividad física y que la complicación más común fue la cardiopatía isquémica

Development of estimates of dietary nitrates, nitrites, and nitrosamines for use with the short willet food frequency questionnaire

<p>Abstract</p> <p>Background</p> <p>Studies have suggested that nitrates, nitrites, and nitrosamines have an etiologic role in adverse pregnancy outcomes and chronic diseases such as cancer. Although an extensive body of literature exists on estimates of these compounds in foods, the extant data varies in quality, quantified estimates, and relevance.</p> <p>Methods</p> <p>We developed estimates of nitrates, nitrites, and nitrosamines for food items listed in the Short Willet Food Frequency Questionnaire (WFFQ) as adapted for use in the National Birth Defects Prevention Study. Multiple reference databases were searched for published literature reflecting nitrate, nitrite, and nitrosamine values in foods. Relevant published literature was reviewed; only publications reporting results for items listed on the WFFQ were selected for inclusion. The references selected were prioritized according to relevance to the U.S. population.</p> <p>Results</p> <p>Based on our estimates, vegetable products contain the highest levels of nitrate, contributing as much as 189 mg/serving. Meat and bean products contain the highest levels of nitrites with values up to 1.84 mg/serving. Alcohol, meat and dairy products contain the highest values of nitrosamines with a maximum value of 0.531 μg/serving. The estimates of dietary nitrates, nitrites, and nitrosamines generated in this study are based on the published values currently available.</p> <p>Conclusion</p> <p>To our knowledge, these are the only estimates specifically designed for use with the adapted WFFQ and generated to represent food items available to the U.S. population. The estimates provided may be useful in other research studies, specifically in those exploring the relation between exposure to these compounds in foods and adverse health outcomes.</p

Restoration of p16INK4A protein induces myogenic differentiation in RD rhabdomyosarcoma cells

p16INK4A (p16) tumour suppressor induces growth arrest by inhibiting function of cyclin-dependent kinase (CDK)4 and CDK6. Homozygous p16 gene deletion is frequent in primary rhabdomyosarcoma (RMS) cells as well as derived cell lines. To confirm the significance of p16 gene deletion in tumour biology of RMS, a temperature-sensitive p16 mutant (E119G) gene was retrovirally transfected into the human RMS cell line RD, which has homozygous gene deletion of p16 gene. Decrease from 40°C (restrictive) to 34°C (permissive) culture temperature reduced CDK6-associated kinase activity and induced G1 growth arrest. Moreover, RD-p16 cells cultured under permissive condition demonstrated differentiated morphology coupled with expressions of myogenin and myosin light chain. These suggest that deletion of p16 gene may not only facilitate growth but also inhibit the myogenic differentiation of RD RMS cells. © 1999 Cancer Research Campaig

Maternal characteristics associated with the dietary intake of nitrates, nitrites, and nitrosamines in women of child-bearing age: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Multiple <it>N</it>-nitroso compounds have been observed in animal studies to be both mutagenic and teratogenic. Human exposure to <it>N</it>-nitroso compounds and their precursors, nitrates and nitrites, can occur through exogenous sources, such as diet, drinking water, occupation, or environmental exposures, and through endogenous exposures resulting from the formation of <it>N</it>-nitroso compounds in the body. Very little information is available on intake of nitrates, nitrites, and nitrosamines and factors related to increased consumption of these compounds.</p> <p>Methods</p> <p>Using survey and dietary intake information from control women (with deliveries of live births without major congenital malformations during 1997-2004) who participated in the National Birth Defects Prevention Study (NBDPS), we examined the relation between various maternal characteristics and intake of nitrates, nitrites, and nitrosamines from dietary sources. Estimated intake of these compounds was obtained from the Willet Food Frequency Questionnaire as adapted for the NBDPS. Multinomial logistic regression models were used to estimate odds ratios and 95% confidence intervals for the consumption of these compounds by self-reported race/ethnicity and other maternal characteristics.</p> <p>Results</p> <p>Median intake per day for nitrates, nitrites, total nitrites (nitrites + 5% nitrates), and nitrosamines was estimated at 40.48 mg, 1.53 mg, 3.69 mg, and 0.472 μg respectively. With the lowest quartile of intake as the referent category and controlling for daily caloric intake, factors predicting intake of these compounds included maternal race/ethnicity, education, body mass index, household income, area of residence, folate intake, and percent of daily calories from dietary fat. Non-Hispanic White participants were less likely to consume nitrates, nitrites, and total nitrites per day, but more likely to consume dietary nitrosamines than other participants that participated in the NBDPS. Primary food sources of these compounds also varied by maternal race/ethnicity.</p> <p>Conclusions</p> <p>Results of this study indicate that intake of nitrates, nitrites, and nitrosamines vary considerably by race/ethnicity, education, body mass index, and other characteristics. Further research is needed regarding how consumption of foods high in nitrosamines and <it>N</it>-nitroso precursors might relate to risk of adverse pregnancy outcomes and chronic diseases.</p

The effects of clinical facilitators’ pedagogic practices on learning opportunities for students who speak English as an additional language: An ethnographic study

© 2018 Elsevier Ltd Background: Increasing numbers of undergraduate nursing students speak English as an additional language. Clinical placements can be difficult for many of these students and their clinical facilitators. The causes of challenges are often reported to be students’ lack of English language ability or, for some students, learning styles that are not suited to Western style education. Objective: The purpose of this research was to investigate how clinical facilitators’ pedagogic practices in hospital settings enabled or constrained the learning of students for whom English was an additional language. Method: This research used an ethnographic design to observe the interactions of twenty-one first year students for whom English is an additional language, and their three facilitators. Observations occurred during three two-week clinical placement blocks, in three large metropolitan hospitals in Australia. Written ethnographic field notes were made during the observations. Field notes were analysed in two stages: firstly, to identify major themes, and secondly, to map the spaces and activities where facilitators and students interacted. Results: The study found that there were multiple learning spaces in the hospitals, each of which was associated with particular learning activities between facilitators and students. These activities provided access to opportunities for learning core nursing skills, as well as for socialisation into the language of nursing. However, not all students had access to these opportunities. The pedagogic practices facilitators used created or constrained learning opportunities for students. Conclusion: This paper proposes a new way of thinking about the supervision of students for whom English is an additional language in clinical settings. Rather than focusing on a lack of English language proficiency or cultural heritage factors, it proposes that a guided approach to using spaces and activities can maximise students’ opportunities for learning