Summative assessment of clinical practice of student nurses : a review of the literature

Objectives: To describe assessment of nursing student’s clinical practice concerned nursing education. Design: Systematic review and synthesis of qualitative and quantitative studies. Data sources: The data were collected with the support of an information specialist from scientific databases Cinahl, PubMed, Medic, ISI Web of Science, Cochrane library and Eric published in January 2000 – May 2014. All of the included studies citations were also performed. Methods: 725 articles concerned with nurse student clinical practice assessment were identified. After inclusion and exclusion criteria were met 23 articles for selected for critical review. Two independent reviewers selected the studies according to the inclusion criteria. These articles were analyzed using content analysis. Results: Findings suggest that the assessment process of nursing students’ clinical practice lacks consistency, it is open to the subjective bias of the assessor and the quality of assessment varies greatly. Nursing students clinical assessment was divided into 3 themes: acts (things to do) before final assessment, the actual final assessment situation and the acts after the final assessment situation. Mentors and students need orientation to the assessment process and to the paperwork by teachers. Terminology on evaluation forms is sometimes so difficult to grasp, that the mentors did not understand what they mean. There is no consensus about written assignments’ ability to describe the students’ skills. Mentors have timing problems to ensure relevant assessment of student nurses. At the final interview students normally self assess their performance, the mentor assesses by interview and by written assignments whether the student has achieved the criteria and role of the teacher is to support the mentor and the student in appropriate assessment. The variety of patient treatment environments in which nursing students do their clinical practice periods is challenging also for the assessment of nursing students’ expertise. Mentors alone want that clinical practice is a positive experience and it might lead to higher grades than what nurse student competency earns. It is very rare that students fail their clinical practice, if the student does not achieve the clinical competencies they are allowed to have extra time in clinical areas until they will be assessed as competent. Conclusions: This systematic review provides a description of challenges in nursing students’ assessment in clinical settings. Further research needs to be carried out to have more knowledge of final assessment in the end of the clinical practice. Through further research it will be possible to have better methods for high quality assessment processes and feedback to nurse students. Quality in assessment provides better nurses and therefore better patient safety

Baryon Magnetic Moments and Axial Coupling Constants with Relativistic and Exchange Current Effects

The large relativistic corrections to the constituent quark current operators improve the predictions for the axial couplings of the baryons, but worsen those for their magnetic moments. The exchange current corrections that are associated with flavor and spin dependent hyperfine interactions between the quarks with a form suggested by pseudoscalar meson exchange can compensate the relativistic corrections to the baryon magnetic moments. This is demonstrated by a calculation of the magnetic moments of the non-strange and strange baryons using wave functions and exchange current operators, which correspond to a recent phenomenological spin- and flavor dependent interquark interaction model with a linear confining interaction, which yields a spectrum close to the empirical one. The possibility that part of the flavor and spin dependent interaction could be due to vector and axial-vector exchange is explored.Comment: Confinement exchange current contribution included, results improved, coauthor list expande

Mountaineering – A Combinatory Approach for Identifying Lead Users and Other Rare Research Subjects

User innovation is common in many domains, and has been found concentrated in few individuals, lead users. Particularly with regard to a given product or service development project, such rare research subjects can be difficult and resource intensive to identify. Several alternative methods are common in the lead-user identification process, but according to dominant practitioner experience, the searches tend not to follow just one of them, but rather are inclined to involve the integration of several methods. This integration of alternative search methods has not, however, been discussed properly to date. The present state of affairs can make the lead-user identification process appear either as simple recipe following or as a mysterious process. We argue for a realistic middle ground between these extreme depictions, and propose an integrative search strategy labeled “mountaineering” towards users with the sought-after characteristics, lead userness in case of lead users. Through four principal and two supportive cases of mountaineering search, we elaborate some of the alternatives and choices in moving from one search method to another as responses to contingencies in particular searches. This elaboration of actual search experiences complements established depictions of ideal search processes and analytical comparisons between particular search methods

Outcome after Hybrid Outflow Interventions for Chronic Limb-threatening Ischemia

Background and Aims: Because chronic limb-threatening ischemia (CLTI) is often associated with multilevel arterial disease, it usually requires revascularization at different sites of the limb vasculature. We aim to assess the outcome of the hybrid interventions including open surgical revascularization together with outflow segment percutaneous transluminal angioplasty (PTA) in patients with chronic limb-threatening ischemia. Material and Methods: This study included all hybrid outflow-PTA interventions (n = 80) on patients suffering from CLTI performed in Helsinki University Hospital between 2003 and 2015. Follow-up ended on 31 December 2019. Patient data were prospectively collected into our vascular registry and scrutinized retrospectively. Thirty-one patients (39%) suffered from rest pain (Rutherford category IV) and 49 patients (61%) had ischemic ulcers (Rutherford category V-VI). The most common open surgical procedure was femoral endarterectomy (n = 63, 79%) and the most common endovascular procedure was superficial femoral artery percutaneous transluminal angioplasty (n = 65, 81%). Mean follow-up time was 56 months (range: 4 days-183 months). Results: Limb salvage was at 30 days-92%, at 1 year-91%, and at 5 and 10 years-86%. Survival and amputation-free survival were at 30 days-93% and 86%, at 1 year-80% and 76%, at 5 years-51% and 48%, and at 10 years-21% and 21%. Wound healing at 3, 6, and 12 months was 48%, 71%, and 87%. Freedom from target lesion revascularization was at 30 days-97%, at 1 year-88%, at 5 years-72%, and at 10 years-66%. Conclusion: Hybrid outflow revascularization is an important tool in the vascular surgeon's armamentarium for treatment of patients with multilevel arterial disease causing chronic limb-threatening ischemia.Peer reviewe

Is there diquark clustering in the nucleon?

It is shown that the instanton-induced interaction in qq pairs, iterated in t-channel, leads to a meson-exchange interactions between quarks. In this way one can achieve a simultaneous understanding of low-lying mesons, baryons and the nuclear force. The discussion is general and does not necessarily rely on the instanton-induced interaction. Any nonperturbative gluonic interaction between quarks, which is a source of the dynamical chiral symmetry breaking and explains the $\pi$ - $\rho$ mass splitting, will imply an effective meson exchange picture in baryons. Due to the (anti)screening there is a big difference between the initial 't Hooft interaction and the effective meson-exchange interaction. It is demonstrated that the effective meson-exchange interaction, adjusted to the baryon spectrum, does not bind the scalar diquark and does not induce any significant quark-diquark clustering in the nucleon because of the nontrivial role played by the Pauli principle.Comment: Final version to appear in Phys. Rev. D; typos have been corrected; some formulae have been written in a more detailed form; some references have been update

Artturi Assists Finnish Advisers and Farmers to Succeed in Grass-Based Dairy Production

Artturi is a collective name for a wide range of services. It is a common tool for different bodies who share an interest in strengthening grass-based dairy production in Finland: research, advisory service and industries. The Service is named after A. I. (Artturi Ilmari) Virtanen, the Finnish scientist who was awarded the Nobel prize in 1945, partly based on his work in developing the ensiling process of grass. The Artturi web site is available in Internet at: http://www.agronet.fi/artturi. Access to Artturi Services is free and no registration is required. The language used is Finnish. During summer 2003, 15,000 visits were recorded at the web site

Vältä pregabaliinia ja trisyklisiä masennuslääkkeitä iäkkään hoidossa

Amitriptyliini, nortriptyliini ja pregabaliini ovat yli 75-vuotiaiden hoidossa vältettäviä lääkeaineita. Ne saattavat lisätä kaatumisia ja murtumia sekä heikentää kognitiota ja aiheuttaa sekavuustiloja, muistuttaa Kela lääke-määräyspalautteessaan

Sustainability of cellulose dissolution and regeneration in 1,5-diazabicyclo[4.3.0]non-5-enium acetate : a batch simulation of the IONCELL-F process

The recyclability of 1,5-diazabicyclo[4.3.0] non-5-enium acetate ([DBNH][OAc]), as a direct dissolution solvent for cellulose, was evaluated during laboratory scale recycling trials. The main objective was to simulate the conditions of a spinning bath from a Lyocell-type air-gap spinning process, called the IONCELL-F process. The saline solution was then concentrated, recycled and reused as many times as possible before cellulose dissolution was no longer possible. The chemical compositions of the ionic liquid and pulp were recorded throughout the experiments. The results of the experiments showed that [DBNH][OAc] can be recycled from aqueous media with an average recovery rate of 95.6 wt% using basic laboratory equipment, without any further process intensification or optimisation. The recycling of the ionic liquid did not change the chemical composition or degree of polymerisation of the recovered pulp but the colour of the regenerated pulps gradually darkened as the recycling times increased. The ionic liquid was found to hydrolyse 6.0-13.6 mol% per cycle, under these conditions. The build-up of the hydrolysis product, 3-( aminopropyl)-2-pyrrolidonium acetate, killed the dissolution feature at between 30.6-45.6 wt% hydrolysis product. The enzymatic digestibility of the regenerated pulp samples was studied with both a monocomponent endoglucanase and a cellulase mixture. The amount of residual [DBNH][OAc] in the regenerated pulps was determined, by both NMR and capillary electrophoresis. Although hydrolysis of the ionic liquid occurs, this study clearly shows potential for industrial application, with appropriate process equipment and recycling conditions.Peer reviewe

Vielä iäkkäiden neuropaattisen kivun hoidosta

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