Nurse Educators\u27 Perspectives of Supplemental Computer-Assisted Formative Assessment in an Associate Degree Nursing Program

Despite the implementation of various strategies to improve outcomes, the pass rates for the National Council Licensure Exam for Registered Nurses (NCLEX-RN) for an associate degree nursing (ADN) program continue to decrease. This study examined the use of a supplemental computer-assisted formative assessment (SCAFA) as a strategy for NCLEX-RN success. A qualitative case study with a theoretical framework based on constructivism was designed to investigate nurse educators\u27 perspectives of this particular strategy for successful outcomes. To explore these perspectives, data were collected from face-to-face interviews with nurse educators and from program documents from 1 ADN program in the southeastern United States. Guiding research questions explored nurse educators\u27 perceptions of SCAFA and determined if and how data from these assessments were utilized. The data were analyzed using lean coding to determine emerging themes. The findings showed that a lack of consistency in the use of this tool diminishes the effectiveness of this supplemental strategy. Additional themes that emerged: educator and student attitudes, orientation and SCAFA process, resource allocation, training and preparation, and data-driven decision making. These findings were used to design a professional development project focused on the effective use of SCAFA throughout the nursing program. The study and project are expected to promote positive social change by contributing to the body of evidence on computer-assisted formative assessment, bolstering student and nurse educator learning, increasing the number of nursing students who are prepared to successfully pass the NCLEX-RN, improving program outcomes, and contributing to the professional nursing workforce

Coming of Age in Neoliberal New York

Thirty years of neoliberal policies have left New York a divided city, with ever-rising rates of income inequality and widening social disparity. Structural transformations associated with global capitalism have led to divergent experiences for male and female youth coming of age in the 21st century. Girls are experiencing greater social integration and social mobility whereas, boys are facing social exclusion and limited opportunities. As young men precariously forge new transitions to adulthood, young women are constructed as ideal flexible subjects, benefiting from feminist achievements, and advancing in the new service economy. Yet in reality, girls continue to face gendered base violence, sexism, and burdens of responsibilities. Through this lens, I examine how gender operates as an organizing principle in young people\u27s lives today in the Lower East Side (LES) of New York City. This study also documents how people create cultural alternatives that reflect their values and progressive politics and analyzes how this has been down in the past. It offers an organizational case study of The Lower Eastside Girls Club in an effort to increase our understanding of the history and significance of a successful struggle to educate, employ, and carve out a safe space for women and girls in neoliberal New York. It documents how the Girls Club builds upon a legacy of grassroots initiatives in the LES, including the settlement house movement of the Progressive Era and Mobilization for Youth of the 1960\u27s. This study asks: what should an education accomplish in a democracy? (Giroux 2013) It examines the limitations of the Girls Club\u27s engaged practice of uplift and empowerment in relation to its progressive politics and critical pedagogy. I suggest that education is a terrain in the right to the city (Lefebvre 1968), and that the Girls Club, in constructing alternative models of education and community engagement, is locally engaging in a broader struggle for social justice, albeit with limited success. This study concludes with an analysis of Girls Club\u27s efforts to push forth a community-led development model that puts women and youth at the center, melding the politics of Jane Addams and Jane Jacobs and offering an alternative urban vision

Factors associated with annual-interval mammography for women in their 40s

Evidence is mounting that annual mammography for women in their 40s may be the optimal schedule to reduce morbidity and mortality from breast cancer. Few studies have assessed predictors of repeat mammography on an annual interval among these women

ARCHES: A Randomized, Phase III Study of Androgen Deprivation Therapy With Enzalutamide or Placebo in Men With Metastatic Hormone-Sensitive Prostate Cancer

PURPOSE: Enzalutamide, a potent androgen-receptor inhibitor, has demonstrated significant benefits in metastatic and nonmetastatic castration-resistant prostate cancer. We evaluated the efficacy and safety of enzalutamide in metastatic hormone-sensitive prostate cancer (mHSPC). METHODS: ARCHES (ClinicalTrials.gov identifier: NCT02677896) is a multinational, double-blind, phase III trial, wherein 1,150 men with mHSPC were randomly assigned 1:1 to enzalutamide (160 mg/day) or placebo, plus androgen deprivation therapy (ADT), stratified by disease volume and prior docetaxel chemotherapy. The primary end point was radiographic progression-free survival. RESULTS: As of October 14, 2018, the risk of radiographic progression or death was significantly reduced with enzalutamide plus ADT versus placebo plus ADT (hazard ratio, 0.39; 95% CI, 0.30 to 0.50; P < .001; median not reached v 19.0 months). Similar significant improvements in radiographic progression-free survival were reported in prespecified subgroups on the basis of disease volume and prior docetaxel therapy. Enzalutamide plus ADT significantly reduced the risk of prostate-specific antigen progression, initiation of new antineoplastic therapy, first symptomatic skeletal event, castration resistance, and reduced risk of pain progression. More men achieved an undetectable prostate-specific antigen level and/or an objective response with enzalutamide plus ADT (P < .001). Patients in both treatment groups reported a high baseline level of quality of life, which was maintained over time. Grade 3 or greater adverse events were reported in 24.3% of patients who received enzalutamide plus ADT versus 25.6% of patients who received placebo plus ADT, with no unexpected adverse events. CONCLUSION: Enzalutamide with ADT significantly reduced the risk of metastatic progression or death over time versus placebo plus ADT in men with mHSPC, including those with low-volume disease and/or prior docetaxel, with a safety analysis that seems consistent with the safety profile of enzalutamide in previous clinical trials in castration-resistant prostate cancer

Caregiver Behavior Change for Child Survival and Development in Low- and Middle-Income Countries: An Examination of the Evidence

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children’s Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers’ behaviors are given

The efficacy and safety of enzalutamide with trastuzumab in patients with HER2+ and androgen receptor-positive metastatic or locally advanced breast cancer

Purpose: Androgen receptor (AR) expression occurs in up to 86% of human epidermal growth factor receptor 2-positive (HER2+) breast cancers. In vitro, AR inhibitors enhance antitumor activity of trastuzumab, an anti-HER2 antibody, in trastuzumab-resistant HER2+ cell lines. This open-label, single-arm, phase II study evaluated the efficacy and safety of enzalutamide, an AR-signaling inhibitor, in patients with advanced HER2+ AR+ breast cancer previously treated with trastuzumab. Methods: Eligible patients had measurable or non-measurable evaluable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, Eastern Cooperative Oncology Group status 64 1, no history of brain metastases, and previously received 65 1 anti-HER2 regimen for advanced disease. Patients received 160\ua0mg oral enzalutamide daily and 6\ua0mg/kg intravenous trastuzumab every 21\ua0days until disease progression or unacceptable toxicity. Primary end point was clinical benefit rate at 24\ua0weeks (CBR24); secondary end points included progression-free survival (PFS) and safety. Results: Overall, 103\ua0women were enrolled [median age 60\ua0years (range 34\u201383)]; 62% had received 65 3\ua0lines of prior anti-HER2 therapy. CBR24, comprising patients with confirmed partial responses (5%) and durable stable disease at 24\ua0weeks (19%), was 24% in the efficacy evaluable set (n = 89). CBR24 did not seem related to AR-expression levels or hormone receptor status. Median PFS was 3.4\ua0months (95% confidence interval 2.0\u20133.8). Overall, 97 (94%) patients experienced treatment-emergent adverse events (TEAEs), with fatigue most common (34%). Dyspnea (4%) and malignant neoplasm progression (3%) were the only TEAEs grade 65 3 reported in 65 3\ua0patients. 22 patients (21%) reported serious TEAEs. Four patients (4%) experienced fatal, non-drug-related TEAEs. Conclusions: Enzalutamide plus trastuzumab was well tolerated, and a subset of patients in this heavily pretreated population had durable disease control. Determination of biomarkers is needed to identify patients most likely to benefit from this combination. ClinicalTrials.gov number: NCT0209196

Caregiver Behavior Change for Child Survival and Development in Low- and Middle-Income Countries: An Examination of the Evidence

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children’s Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers’ behaviors are given

Report-back for geo-referenced environmental data: A case study on personal monitoring of temperature in outdoor workers

Few studies have evaluated the benefits of reporting back participatory environmental monitoring results, particularly regarding participant motivation toward behavioural modification concerning workplace heat exposure. This study evaluated the individual data report-back for geo-located environmental temperature and time activity patterns in grounds maintenance crews in three geographic regions across the South-eastern United States. Surveys collected information on worker interpretation of their results and intended action(s) to reduce heat exposure. Worker response was highly positive, especially among more experienced workers who expressed a greater willingness to modify personal behaviour to reduce heat stress. Individual-level report-back of environmental data is a powerful tool for individuals to understand and act on their personal exposure to heat