Teaching Excellence: What Great Teachers Teach Us

Given the shortage of nurse educators, we sought to better understand teaching excellence because it is crucial for developing the next generation of nurses. A grounded theory approach was used. The sample included 17 respondents, thought to be excellent teachers, from universities across the United States. Consenting respondents were asked, “What do you do to bring nursing to life with your students?” Using line-by-line coding and the constant comparative method, five major themes emerged: (a) engagement, (b) relevance, (c) student centeredness, (d) facilitation of learning, and (e) dynamic process of becoming an excellent nursing educator. We found that the core category, engagement, included the faculty being (a) current and knowledgeable, (b) being clear in communication of objectives/outcomes, (c) being student centered, (d) being able to draw all students into active questioning and learning so that the process of discovery is enjoyable, and (e) using multiple strategies in teaching the content. The process of becoming an excellent teacher involved “change from ‘instiller’ to ‘facilitator’ and laid the foundation for continued development of my teaching self.” Those beginning to teach or seeking to improve their teaching may find the results enlightening

U.S. Army Small Space Update

In December 2010, the U.S. Army flew its first satellite in 50 years, the SMDC-ONE CubeSat. Placed in a very low orbit, the first SMDC-ONE mission lasted only 35 days but enjoyed great success in demonstrating the viability of CubeSats to perform exfiltration of unattended ground sensors data and serve as a communications relay between ground stations over 1000 land miles apart. The success of SMDC-ONE helped shape the U.S. Army’s Space and Missile Defense Command’s (SMDC) programmatic goals for finding new and innovative ways to implement space applications and technologies that aid the warfighter. Since 2010, SMDC has flown ten additional CubeSats including the three SMDC Nanosatellite Program-3 (SNaP) CubeSats currently on orbit (launched October 2015). This paper addresses several SMDC satellite-related development efforts including SNaP, Army Resilient Global On-the-move SATCOM (ARGOS) Ka-band communications microsatellites, Kestrel Eye (an imaging microsatellite), Kestrel Eye Ground Station (KEGS), Common Ground Station (CGS) for all future Army small satellites, supporting technologies including Small Business Innovative Research (SBIR) efforts, the Concepts Analysis Laboratory, SMDC Space Laboratory, the ACES RED effort and earlier responsive launch vehicle activities. Several of the lessons learned from previous as well as ongoing satellite activities are also covered

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes

Quality of life: The humanbecoming perspective. A descriptive exploratory study

The purpose of this study, guided by Parse\u27s humanbecoming theory and the descriptive-exploratory design, was to uncover the meaning of quality of life as a lived experience for young African American women living with breast cancer. Breast cancer is the leading cause of cancer death in women ages 15 to 54 (American Cancer Society [ACS], 2008 & Young Survivors Coalition, 2008). Approximately 1,300 women age 40 or less will die from this disease (ACS, 2008). As a vulnerable population, young African American women experience the greatest breast cancer burden in the United States, experience the highest incidence, and have the poorest outcomes from breast cancer (ACS, 2008; National Cancer Institute, 2007). Currently, no peer-reviewed research exists regarding quality of life and young African American women. In this study, participants discussed changes in their day-to-day activities, methods of treatment, side effects, interaction with others, and living a fulfilling life.Through dwelling with the descriptions of three themes of shared meaning, the researcher generated concepts to form the unified description of the experience of quality of life for the participants. The researcher found that quality of life is contemplating challenging times, while moving closer to and away from others in living with opportunities and restrictions, while fashioning a fulfilling life amid torment. This research provides new knowledge for nursing and adds to the quality of life literature an understanding of a universal lived experience. The findings involve the participant\u27s hopes, dreams, and envisioning of the not-yet, as well as their participation in the day-to-day struggle of living with the now and the not-yet all-at-once when a life threatening disease and relationships pose challenges. This research expands Parse\u27s theory of humanbecoming in relation to quality of life. Recommendations for further research include additional research with young African American women related to quality of life and the unified description identified in this study. Conclusions and recommendations for clinical practice, academia, and future research are offered

Quality of Life: The Humanbecoming Perspective, A Descriptive Exploratory Study

The purpose of this study, guided by Parse\u27s humanbecoming theory and the descriptive-exploratory design, was to uncover the meaning of quality of life as a lived experience for young African American women living with breast cancer. Breast cancer is the leading cause of cancer death in women ages 15 to 54 (American Cancer Society [ACS], 2008 & Young Survivors Coalition, 2008). Approximately 1,300 women age 40 or less will die from this disease (ACS, 2008). As a vulnerable population, young African American women experience the greatest breast cancer burden in the United States, experience the highest incidence, and have the poorest outcomes from breast cancer (ACS, 2008; National Cancer Institute, 2007). Currently, no peer-reviewed research exists regarding quality of life and young African American women. In this study, participants discussed changes in their day-to-day activities, methods of treatment, side effects, interaction with others, and living a fulfilling life.Through dwelling with the descriptions of three themes of shared meaning, the researcher generated concepts to form the unified description of the experience of quality of life for the participants. The researcher found that quality of life is contemplating challenging times, while moving closer to and away from others in living with opportunities and restrictions, while fashioning a fulfilling life amid torment. This research provides new knowledge for nursing and adds to the quality of life literature an understanding of a universal lived experience. The findings involve the participant\u27s hopes, dreams, and envisioning of the not-yet, as well as their participation in the day-to-day struggle of living with the now and the not-yet all-at-once when a life threatening disease and relationships pose challenges. This research expands Parse\u27s theory of humanbecoming in relation to quality of life. Recommendations for further research include additional research with young African American women related to quality of life and the unified description identified in this study. Conclusions and recommendations for clinical practice, academia, and future research are offered

Guidelines of care for primary cutaneous melanoma

J Am Acad Dermatol 2001;45:579-86