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

Dispersion from C^alpha or N^H: 4D experiments for backbone resonance assignment of intrinsically disordered proteins

N-HSQC spectrum. Application of these 4D experiments is demonstrated using BilRI (165 aa), an outer-membrane intrinsically disordered protein from the opportunistic oral pathogen Aggregatibacter actinomycetemcomitans. BilRI amino acid sequence encompasses three very similar repeats with a 13-residue identical stretch in two of them

Culturing of Selenastrum on diluted composting fluids; conversion of waste to valuable algal biomass in presence of bacteria

© 2017 The AuthorsGrowth and fatty acid production of microalga Selenastrum sp. with associated bacteria was studied in lab-scale experiments in three composting leachate liquids. Nutrient reduction in cultures was measured at different initial substrate strengths. A small, pilot-scale photobioreactor (PBR) was used to verify lab-scale results. Similar growth conditions supported growth of both Selenastrum and bacteria. CO2 feed enhanced the production of biomass and lipids in PBR (2.4 g L−1 and 17% DW) compared to lab-scale (0.1–1.6 g L−1 and 4.0–6.5% DW) experiments. Also prolonged cultivation time increased lipid content in PBR. At both scales, NH4-N with an initial concentration of ca. 40 mg L−1 was completely removed from the biowaste leachate. In lab-scale, maximal COD reduction was over 2000 mg L−1, indicating mixotrophic growth of Selenastrum. Co-cultures are efficient in composting leachate liquid treatment, and conversion of waste to biomass is a promising approach to improve the bioeconomy of composting plants

Geographic origin as a determinant of left ventricular mass and diastolic function - the Cardiovascular Risk in Young Finns Study

Aims: Eastern Finns have higher risk of coronary heart disease (CHD) and carotid intima-media thickness than western Finns although current differences in CHD risk factors are minimal. Left ventricular (LV) mass and diastolic function predict future cardiovascular events but their east-west differences are unknown. We examined the association of eastern/western baseline origin with LV mass and diastolic function. Methods : The study population included 2045 subjects of the Cardiovascular Risk in Young Finns Study with data from the baseline survey (1980) and the latest follow-up (2011) when echocardiography was performed at the age of 34-49 years. Results: Subjects with eastern baseline origin had in 2011 higher LV mass (139 +/- 1.0 vs. 135 +/- 1.0 g, p=0.006) and E/e-ratio indicating weaker LV diastolic function (4.86 +/- 0.03 vs. 4.74 +/- 0.03, p=0.02) than western subjects. Results were independent of age, sex, area of examination and CHD risk factors such as blood pressure and BMI (LV mass indexed with height: pPeer reviewe

Cardiovascular Risk Factor Trajectories Since Childhood and Cognitive Performance in Midlife The Cardiovascular Risk in Young Finns Study

Background: Cardiovascular risk factors, such as high blood pressure, adverse serum lipids, and elevated body mass index in midlife, may harm cognitive performance. It is important to note that longitudinal accumulation of cardiovascular risk factors since childhood may be associated with cognitive performance already since childhood, but the previous evidence is scarce. We studied the associations of cardiovascular risk factors from childhood to midlife, their accumulation, and midlife cognitive performance. Methods: From 1980, a population-based cohort of 3596 children (3-18 years of age) have been repeatedly followed up for 31 years. Blood pressure, serum lipids, and body mass index were assessed in all follow-ups. Cardiovascular risk factor trajectories from childhood to midlife were identified using latent class growth mixture modeling. Cognitive testing was performed in 2026 participants 34 to 49 years of age using a computerized test. The associations of the cardiovascular risk factor trajectories and cognitive performance were studied for individual cardiovascular risk factors and cardiovascular risk factor accumulation. Results: Consistently high systolic blood pressure (beta=-0.262 SD [95% CI, -0.520 to -0.005]) and serum total cholesterol (beta=-0.214 SD [95% CI, -0.365 to -0.064]) were associated with worse midlife episodic memory and associative learning compared with consistently low values. Obesity since childhood was associated with worse visual processing and sustained attention (beta=-0.407 SD [95% CI, -0.708 to -0.105]) compared with normal weight. An inverse association was observed for the cardiovascular risk factor accumulation with episodic memory and associative learning (P for trend=0.008; 3 cardiovascular risk factors: beta=-0.390 SD [95% CI, -0.691 to -0.088]), with visual processing and sustained attention (P for trend Conclusions: Longitudinal elevated systolic blood pressure, high serum total cholesterol, and obesity from childhood to midlife were inversely associated with midlife cognitive performance. It is important to note that the higher the number of cardiovascular risk factors, the worse was the observed cognitive performance. Therefore, launching preventive strategies against cardiovascular risk factors beginning from childhood might benefit primordial promotion of cognitive health in adulthood.Peer reviewe

Conversion of biowaste leachate to valuable biomass and lipids in mixed cultures of Euglena gracilis and chlorophytes

© 2018 The Authors Microalgae are a sustainable alternative for production of valuable omega −3 fatty acids (FAs), but high production costs limit commercialization. Utilization of waste as a nutrient source increases the economics of the cultivation process. Additionally, using mixed algal cultures instead of monocultures makes the cultivation process more flexible and can increase biomass and lipid production. Here, the growth and lipid production of microalgae Euglena gracilis, Selenastrum sp. and, Chlorella sorokiniana were studied in mono- and mixed cultures in small and pilot scale experiments in biowaste leachate. In pilot scale, also nutrient reduction and the number of bacteria were analyzed. Biomass production in the most productive mixed cultures was similar, but not higher than in most productive monocultures. The lipid production was highest in the small-scale monoculture of Selenastrum (10.4% DW) and in the pilot scale culture of Selenastrum with E. gracilis (11.1% DW). The content of alpha-linolenic acid (ALA) increased and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) remained stable during the cultivation period in all pilot scale cultures. However, increases in biomass and lipid production toward the end of the cultivation resulted in higher EPA and DHA yields in the well growing monoculture of E. gracilis and in the mixed culture of E. gracilis with Selenastrum. Co-cultivation of E. gracilis and Selenastrum also had a positive influence on nutrient uptake and resistance against bacteria. This type of mixed culture may be a good option for commercialization. However, as shown here, minor changes in cultivation conditions can rapidly result in dominance of a subdominant strain, and thus the stability of strain performance and production of desired FAs needs further investigation

Arabidopsis RCD1 coordinates chloroplast and mitochondrial functions through interaction with ANAC transcription factors

Reactive oxygen species (ROS)-dependent signaling pathways from chloroplasts and mitochondria merge at the nuclear protein RADICAL-INDUCED CELL DEATH1 (RCD1). RCD1 interacts in vivo and suppresses the activity of the transcription factors ANAC013 and ANAC017, which mediate a ROS-related retrograde signal originating from mitochondrial complex III. Inactivation of RCD1 leads to increased expression of mitochondrial dysfunction stimulon (MDS) genes regulated by ANAC013 and ANAC017. Accumulating MDS gene products, including alternative oxidases (AOXs), affect redox status of the chloroplasts, leading to changes in chloroplast ROS processing and increased protection of photosynthetic apparatus. ROS alter the abundance, thiol redox state and oligomerization of the RCD1 protein in vivo, providing feedback control on its function. RCD1-dependent regulation is linked to chloroplast signaling by 3'-phosphoadenosine 5'-phosphate (PAP). Thus, RCD1 integrates organellar signaling from chloroplasts and mitochondria to establish transcriptional control over the metabolic processes in both organelles.Peer reviewe

Childhood risk factors and carotid atherosclerotic plaque in adulthood: The Cardiovascular Risk in Young Finns Study

BACKGROUND AND AIMS:Carotid plaque is a specific sign of atherosclerosis and adults with carotid plaque are at increased risk for cardiovascular outcomes. Atherosclerosis has roots in childhood and pediatric guidelines provide cut-off values for cardiovascular risk factors. However, it is unknown whether these cut-offs predict adulthood advanced atherosclerosis.METHODS:The Cardiovascular Risk in Young Finns Study is a follow-up of children that begun in 1980 when 2653 participants with data for the present analyses were aged 3-18 years. In 2001 and 2007 follow-ups, in addition to adulthood cardiovascular risk factors, carotid ultrasound data was collected. Long-term burden, as the area under the curve, was evaluated for childhood (6-18 years) risk factors. To study the associations of guideline-based cut-offs with carotid plaque, both childhood and adult risk factors were classified according to clinical practice guidelines.RESULTS:Carotid plaque, defined as a focal structure of the arterial wall protruding into lumen >50% compared to adjacent intima-media thickness, was present in 88 (3.3%) participants. Relative risk for carotid plaque, when adjusted for age and sex, was 3.03 (95% CI, 1.76-5.21) for childhood dyslipidemia, 1.51 (95% CI, 0.99-2.32) for childhood elevated systolic blood pressure, and 1.93 (95% CI, 1.26-2.94) for childhood smoking. Childhood dyslipidemia and smoking remained independent predictors of carotid plaque in models additionally adjusted for adult risk factors and family history of coronary heart disease. Carotid plaque was present in less than 1% of adults with no childhood risk factors.CONCLUSIONS:Findings reinforce childhood prevention efforts and demonstrate the utility of guideline-based cut-offs in identifying children at increased risk for adulthood atherosclerosis.</p

Determinants of left ventricular diastolic function-The Cardiovascular Risk in Young Finns Study

Decreased left ventricular (LV) diastolic function is associated with increased all-cause mortality and risk for a heart failure. The determinants of LV diastolic function have been mainly studied in elderly populations; however, the origin of LV heart failure may relate to the lifestyle factors acquired during the life course. Therefore, we examined biochemical, physiological, and lifestyle determinants of LV diastolic function in 34-49-year-old participants of the Cardiovascular Risk in Young Finns Study (Young Finns Study). In 2011, clinical examination and echocardiography were performed for 1928 participants (880 men and 1048 women; aged 34-49 years). LV diastolic function was primarily defined using E/e-ratio (population mean 4.8, range 2.1-9.0). In a multivariate model, systolic blood pressure (P < 0.005), female sex (P < 0.005), age (P < 0.005), waist circumference (P = 0.024), smoking (P = 0.028), serum alanine aminotransferase (P = 0.032) were directly associated with E/e-ratio, while an inverse association was found for height (P < 0.005). Additionally, a higher E/e-ratio was found in participants with concentric hypertrophy compared to normal cardiac geometry (P < 0.005). Other indicators of the LV diastolic function including E/A-ratio and left atrial volume index showed similarly strong associations with systolic blood pressure and age. In conclusion, we identified systolic blood pressure, waist circumference and smoking as modifiable determinants of the LV diastolic function in the 34-49-year-old participants of the Young Finns Study