Culturally and linguistically diverse nursing students' experiences of integration into the working environment: A qualitative study

Background Understanding how culturally and linguistically diverse students experience clinical practice and their competence development is important to retaining registered nurses. This study aimed to describe culturally and linguistically diverse students' experiences of clinical practice, perceptions of their career path, and intentions to stay in the nursing profession. Methods A descriptive qualitative study was conducted. The participants were culturally and linguistically diverse nursing students (n = 22) from six Finnish higher education institutions. Nine focus-group interviews, with up to six students per group, were conducted during the spring and summer of 2021. Data were analysed using inductive content analysis. Results The factors which affected culturally and linguistically diverse students' intentions to stay in nursing profession in Finland consisted of support during university studies and clinical practice, perceived equality, nursing competence development, successful integration into the workplace and social life, and clinical practice experiences. Conclusions The results support the development of a model for culturally and linguistically diverse nurses' integration into the Finnish health care settings by identifying the key factors for an effective transition to the profession

Collagen XIII secures pre- and postsynaptic integrity of the neuromuscular synapse

© The Author 2017. Published by Oxford University Press. All rights reserved. Both transmembrane and extracellular cues, one of which is collagen XIII, regulate the formation and function of the neuromuscular synapse, and their absence results in myasthenia. We show that the phenotypical changes in collagen XIII knock-out mice are milder than symptoms in human patients, but the Col13a1 -/- mice recapitulate major muscle findings of congenital myasthenic syndrome type 19 and serve as a disease model. In the lack of collagen XIII neuromuscular synapses do not reach full size, alignment, complexity and function resulting in reduced muscle strength. Collagen XIII is particularly important for the preterminal integrity, and when absent, destabilization of the motor nerves results in muscle regeneration and in atrophy especially in the case of slow muscle fibers. Collagen XIII was found to affect synaptic integrity through binding the ColQ tail of acetylcholine esterase. Although collagen XIII is a muscle-bound transmembrane molecule, it also undergoes ectodomain shedding to become a synaptic basal lamina component. We investigated the two forms' roles by novel Col13a1 tm/tm mice in which ectodomain shedding is impaired. While postsynaptic maturation, terminal branching and neurotransmission was exaggerated in the Col13a1 tm/tm mice, the transmembrane form's presence sufficed to prevent defects in transsynaptic adhesion, Schwann cell invagination/retraction, vesicle accumulation and acetylcholine receptor clustering and acetylcholinesterase dispersion seen in the Col13a1 -/- mice, pointing to the transmembrane form as the major conductor of collagen XIII effects. Altogether, collagen XIII secures postsynaptic, synaptic and presynaptic integrity, and it is required for gaining and maintaining normal size, complexity and functional capacity of the neuromuscular synapse

Hoitoketjun kustannus-vaikuttavuusanalyysi sekä sairaanhoitopiirikohtaiset erot aivoinfarktin hoidossa vuosina 1999–2009

Aivoinfarkti on yksi eniten kustannuksia aiheuttavista sairauksista. Kustannusten lisäksi se aiheuttaa myös merkittävää inhimillistä kärsimystä kuoleman ja toimintakyvyn menetyksen kautta. Kalliita tutkimuksia ja hoitoja vaativan akuuttihoidon lisäksi etenkin toimintakykyään merkittävästi menettäneiden jatkohoito sitoo huomattavasti terveydenhuollon resursseja. Sairauden merkittävyyden vuoksi, tulisi sen hoitomenetelmien olla huippuunsa hiotut. Tämän työn tavoitteena on tutkia sairaanhoitopiirikohtaisia eroja aivoinfarktin hoidossa, sekä määrittää koko aivoinfarktin hoitoketjun kustannusvaikuttavuus. Tutkimusaineisto koostuu vuosien 1999–2009 aikana aivoinfarktin sairastaneista potilaista, joista on muodostettu paneeliaineisto vuosittain ja sairaanhoitopiireittäin. Aineiston tutkimusmenetelmät ovat kvantitatiivisia. Tulosten valossa aivoinfarktin hoidon vaikuttavuus on seuranta-aikana parantunut. Kuolleisuus aivoinfarktiin on laskenut ja kotona vietettyjen päivien määrä noussut. Merkittävin kuolleisuuden laskua selittävä tekijä on trendinomainen kehitys sairauden hoidossa, mutta myös lisäkustannuksilla osoitetaan saavutettavan vaikuttavuuslisää. Sairaanhoitopiirien ääripäiden välillä on suuria eroja niin vaikuttavuudessa kuin kustannuksissa. Tulokset ovat hyvin yleistettävissä, sillä niiden taustalla oleva aineisto on todellisesta reaalielämän vaikuttavuudesta kertovaa. Tutkimuksessa on myös heikkouksia, mutta kokonaisuutena voidaan saatuja löydöksiä pitää luotettavina. Löydösten pohjalta herää mielenkiintoisia jatkotutkimussuunnitelmia erityisesti kuntoutuksen ja elämänlaatutiedon osalta

Autoimmune antibodies to collagen XIII in myasthenia gravis patients

Abstract Introduction: Evaluation of the nerve fascicular structure can be useful in diagnosing nerve damage, but it is a very challenging task with 3T MRI because of limited resolution. In this pilot study, we present the feasibility of high‐resolution 7T MRI for examining the nerve fascicular structure. Methods: A 3‐dimensional (3D) gradient‐spoiled sequence was used for imaging peripheral nerves in extremities. Images acquired with different in‐plane resolutions (0.42 × 0.42 mm vs. 0.12 × 0.12 mm), and different main field strengths (7T vs. 3T) were compared. Results: The individual nerve fascicles were identified at 0.12 × 0.12 mm resolution in both field strengths but not at 0.42 × 0.42 mm resolution. The fascicular structure was more sharply depicted in 7T images than in 3T images. Discussion: High‐resolution 3D imaging with 7T MRI demonstrated feasibility for imaging nerve fascicular structures

Culturally and linguistically diverse nurses’ experiences of how competence facilitates integration into the working environment:a qualitative study

Abstract Aim: This study aims to describe culturally and linguistically diverse nurses’ experiences of how they transferred their competence to meet professional competence requirements in non-English speaking environment. Background: Competence is one factor that affects culturally and linguistically diverse nurses’ integration into the working environment. In this study, knowledge, skills, values and personal traits are included in the holistic competence concept. Design: Qualitative. Methods: A total of 24 culturally and linguistically diverse nurses involved in Finnish health care participated in this qualitative study. Data were collected through snowball sampling during the summer of 2021 using semi-structured interviews. The collected data were analysed using inductive content analysis. Results: The data analysis revealed a total of five main categories describing culturally and linguistically diverse nurses’ experiences: 1) before immigration; 2) competence requirements in the country of immigration; 3) assessment of competencies; 4) support factors; and 5) hardships. Conclusion: Degree recognition, colleagues’ tolerance towards culturally and linguistically diverse nurses at the workplace and continuous education focusing on local language could improve culturally and linguistically diverse nurses’ integration into the working environment

Culturally and linguistically diverse registered nurses’ experiences of integration into nursing workforce:a qualitative descriptive study

Abstract Background: The nursing shortage is a global and ongoing phenomenon that is expected to worsen. In many countries, imbalances in the nursing workforce will require international recruitment and plans to increase domestic and international nursing graduates. Nurses from culturally and linguistically diverse backgrounds have been reported to experience challenges while integrating into the workforce. Aim: To describe culturally and linguistically diverse registered nurses’ experiences of their integration into the Finnish nursing workforce. Methods: The study adopted a qualitative descriptive design. Data were collected during the spring of 2021 from 24 culturally and linguistically diverse registered nurses working in various healthcare settings in Finland. Data were analyzed using content analysis, which resulted in 596 open codes, 21 sub-categories, and 8 categories. Results: According to the performed analysis, culturally and linguistically diverse nurses in Finland face cultural, ethnic and linguistic challenges. Organizational acceptance and acknowledgement of culturally and linguistically diverse nurses’ competence can help decrease the practice of deskilling and the perception that foreign nurses have purely opportunistic goals. Cultural and language learning support, tailored orientation programs, and mentorship are the most common organizational strategies for supporting integration and competence development. The role of the nurse manager and organizational strategies were also identified as essential components of smooth integration, work wellbeing and retention. Conclusions: Finnish healthcare organizations need to implement strategies that support culturally and linguistically diverse nurses’ integration into the workforce. Nurse managers are important leaders that can foster culturally and linguistically diverse nurses’ competence development, ensure the efficient use of their specialized skills, promote work wellbeing, and improve nurse retention

Collagen XIII secures pre- and postsynaptic integrity of the neuromuscular synapse

© The Author 2017. Published by Oxford University Press. All rights reserved. Both transmembrane and extracellular cues, one of which is collagen XIII, regulate the formation and function of the neuromuscular synapse, and their absence results in myasthenia. We show that the phenotypical changes in collagen XIII knock-out mice are milder than symptoms in human patients, but the Col13a1 -/- mice recapitulate major muscle findings of congenital myasthenic syndrome type 19 and serve as a disease model. In the lack of collagen XIII neuromuscular synapses do not reach full size, alignment, complexity and function resulting in reduced muscle strength. Collagen XIII is particularly important for the preterminal integrity, and when absent, destabilization of the motor nerves results in muscle regeneration and in atrophy especially in the case of slow muscle fibers. Collagen XIII was found to affect synaptic integrity through binding the ColQ tail of acetylcholine esterase. Although collagen XIII is a muscle-bound transmembrane molecule, it also undergoes ectodomain shedding to become a synaptic basal lamina component. We investigated the two forms' roles by novel Col13a1 tm/tm mice in which ectodomain shedding is impaired. While postsynaptic maturation, terminal branching and neurotransmission was exaggerated in the Col13a1 tm/tm mice, the transmembrane form's presence sufficed to prevent defects in transsynaptic adhesion, Schwann cell invagination/retraction, vesicle accumulation and acetylcholine receptor clustering and acetylcholinesterase dispersion seen in the Col13a1 -/- mice, pointing to the transmembrane form as the major conductor of collagen XIII effects. Altogether, collagen XIII secures postsynaptic, synaptic and presynaptic integrity, and it is required for gaining and maintaining normal size, complexity and functional capacity of the neuromuscular synapse

Healthcare students’ evaluation of the clinical learning environment and supervision:a cross-sectional study

Abstract Background: The purpose of clinical placements and supervision is to promote the development of healthcare students’ professional skills. High-quality clinical learning environments and supervision were shown to have significant influence on healthcare students’ professional development. Objectives: This study aimed to describe healthcare students’ evaluation of the clinical learning environment and supervision, and to identify the factors that affect these. Design: The study was performed as a cross-sectional study. Methods: The data (n = 1973) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale during the academic year 2015–2016 from all healthcare students (N = 2500) who completed their clinical placement at a certain university hospital in Finland. The data were analysed using descriptive statistics and binary logistic regression analysis. Results: More than half of the healthcare students had a named supervisor and supervision was completed as planned. The students evaluated the clinical learning environment and supervision as ‘good’. The students’ readiness to recommend the unit to other students and the frequency of separate private unscheduled sessions with the supervisor were the main factors that affect healthcare students’ evaluation of the clinical learning environment and supervision. Individualized and goal-oriented supervision in which the student had a named supervisor and where supervision was completed as planned in a positive environment that supported learning had a significant impact on student’s learning. Conclusions: The clinical learning environment and supervision support the development of future healthcare professionals’ clinical competence. The supervisory relationship was shown to have a significant effect on the outcomes of students’ experiences. We recommend the planning of educational programmes for supervisors of healthcare students for the enhancement of supervisors’ pedagogical competencies in supervising students in the clinical practice

Collagen XIII secures pre- and postsynaptic integrity of the neuromuscular synapse

© The Author 2017. Published by Oxford University Press. All rights reserved. Both transmembrane and extracellular cues, one of which is collagen XIII, regulate the formation and function of the neuromuscular synapse, and their absence results in myasthenia. We show that the phenotypical changes in collagen XIII knock-out mice are milder than symptoms in human patients, but the Col13a1 -/- mice recapitulate major muscle findings of congenital myasthenic syndrome type 19 and serve as a disease model. In the lack of collagen XIII neuromuscular synapses do not reach full size, alignment, complexity and function resulting in reduced muscle strength. Collagen XIII is particularly important for the preterminal integrity, and when absent, destabilization of the motor nerves results in muscle regeneration and in atrophy especially in the case of slow muscle fibers. Collagen XIII was found to affect synaptic integrity through binding the ColQ tail of acetylcholine esterase. Although collagen XIII is a muscle-bound transmembrane molecule, it also undergoes ectodomain shedding to become a synaptic basal lamina component. We investigated the two forms' roles by novel Col13a1 tm/tm mice in which ectodomain shedding is impaired. While postsynaptic maturation, terminal branching and neurotransmission was exaggerated in the Col13a1 tm/tm mice, the transmembrane form's presence sufficed to prevent defects in transsynaptic adhesion, Schwann cell invagination/retraction, vesicle accumulation and acetylcholine receptor clustering and acetylcholinesterase dispersion seen in the Col13a1 -/- mice, pointing to the transmembrane form as the major conductor of collagen XIII effects. Altogether, collagen XIII secures postsynaptic, synaptic and presynaptic integrity, and it is required for gaining and maintaining normal size, complexity and functional capacity of the neuromuscular synapse

The ward manager role in the context of nursing and midwifery students’ clinical learning:testing a model

Abstract Aim: To test a model of clinical learning that focuses on the role of the ward manager. Background: The ward manager’s role in supporting clinical learning indirectly focuses on the ward climate connected to students’ clinical placements. In this way, the ward manager influences both nursing care and the pedagogical atmosphere in the ward. Design: Cross-sectional, secondary analysis. Methods: The sample included nursing and midwifery students (N = 5,776, n = 1,900) who had completed their clinical placement. Data were collected with the Clinical Learning Environment, Supervision and Nurse Teacher scale. Structural equation modelling was adopted to test the hypotheses. Results: Estimates of the model parameters demonstrated that a ward manager’s leadership style influences both the premises of nursing at the ward (0.84, p < .001) and the pedagogical atmosphere (0.93, p < .001), although the pedagogical atmosphere affects the mentoring relationship (0.87–0.86, p < .001). Conclusions: Ward managers exert a significant influence on the clinical learning environment via their support for an effective pedagogical atmosphere and, consequently, effective mentoring. Implications for Nursing Management: Leadership style guides both the premises of nursing at the ward and pedagogical atmosphere. These findings recommend that ward managers should be involved in promoting a supportive learning climate, which supports the mentor–student relationship and, eventually, leads to effective clinical learning