Caring attributes and preparedness to care: effects of a pre-enrolled nursing certificate programme in Singapore

Background: Caring is a highly complex and abstract concept, and nurturing a caring attribute among individuals for a nursing career is believed to be best introduced at the start of student journey in preparatory courses specifically designed for nursing. However, because of the need to professionalise nursing, pre-enrolled nursing programmes have been discontinued and replaced by generic healthcare programmes in many parts of the world. Aim: This study aims to evaluate the impact of pre-enrolled certificate nursing education on students’ caring attributes and their preparedness to care. Methodology: A mixed methods approach using unstructured questions and the Caring Behaviour Inventory was employed to determine student caring attributes and their preparedness to care. The participants were final year pre-enrolled nursing students in Singapore. Findings: Students demonstrated attributes of caring based on an average CBI score of 4.55 (SD 0.32). Expressions of professional nurse caring were explicit in students’ entire learning journey and these took various forms of approach embedded in both curricular and extracurricular activites. The study also found that nurturing caring attributes was associated with a high expectation of student social behaviour and closely linked to the increasingly good reputation of nursing as a profession in that region. Conclusions: This study indicates the high potential value of pre-enrolled nursing education for developing the caring attributes of individuals. A nursing-oriented programme title and its high status associated with nursing were critical elements for nurturing the caring attributes. The implications for developments in nurse education and research are discussed

Cooperative Stimulation of Dendritic Cells by Cryptococcus neoformans Mannoproteins and CpG Oligodeoxynucleotides

While mannosylation targets antigens to mannose receptors on dendritic cells (DC), the resultant immune response is suboptimal. We hypothesized that the addition of toll-like receptor (TLR) ligands would enhance the DC response to mannosylated antigens. Cryptococcus neoformans mannoproteins (MP) synergized with CpG-containing oligodeoxynucleotides to stimulate enhanced production of proinflammatory cytokines and chemokines from murine conventional and plasmacytoid DC. Synergistic stimulation required the interaction of mannose residues on MP with the macrophage mannose receptor (MR), CD206. Moreover, synergy with MP was observed with other TLR ligands, including tripalmitoylated lipopeptide (Pam3CSK4), polyinosine-polycytidylic acid (pI:C), and imiquimod. Finally, CpG enhanced MP-specific MHC II-restricted CD4+ T-cell responses by a mechanism dependent upon DC expression of CD206 and TLR9. These data suggest a rationale for vaccination strategies that combine mannosylated antigens with TLR ligands and imply that immune responses to naturally mannosylated antigens on pathogens may be greatly augmented if TLR and MR are cooperatively stimulated.National Institutes of Health (RO1 AI25780, RO1 AI37532, K08 AI 53542

Monitoring Trails and Disturbance in Joshua Tree National Park

Joshua Tree National Park, well known for its recreation activities, is in need of improved vegetation and trail monitoring programs. Specifically, social trails, or trails created by users that deviate from designated paths, are major contributors to vegetation disturbance and loss. Current activity levels are beginning to negatively affect surrounding landscapes. This project was developed to enable staff to monitor large regions of the park without expending significant man-hours or costs. With this in mind, the project was developed using QuickBird satellite imagery as the main component for feature extraction from an ESRI system with the Feature Analyst (FA) and Spatial Analyst extensions. The deliverables for this project were a master geodatabase, vegetation index, and a feature class containing all the social trails within a given region. A customized ArcToolbox and model were developed, in addition to a complete process-flow highlighting the steps required to process and analyze the data. The implemented tools and methods in the project enabled the client to monitor large regions of the park with less effort than field data collection

Caring behaviours of student nurses: Effects of pre-registration nursing education

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care

Gender differences in the pathways from childhood disadvantage to metabolic syndrome in adulthood: An examination of health lifestyles.

We investigate whether socioeconomic status (SES) in childhood shapes adult health lifestyles in domains of physical activity (leisure, work, chores) and diet (servings of healthy [i.e., nutrient-dense] vs. unhealthy [energy-dense] foods). Physical activity and food choices vary by gender and are key factors in the development of metabolic syndrome (MetS). Thus, we examined gender differences in the intervening role of these behaviors in linking early-life SES and MetS in adulthood. We used survey data (n = 1054) from two waves of the Midlife in the U.S. Study (MIDUS 1 and 2) and biomarker data collected at MIDUS 2. Results show that individuals who were disadvantaged in early life are more likely to participate in physical activity related to work or chores, but less likely to participate in leisure-time physical activity, the domain most consistently linked with health benefits. Women from low SES families were exceedingly less likely to complete recommended amounts of physical activity through leisure. Men from low SES consumed more servings of unhealthy foods and fewer servings of healthy foods. The observed associations between childhood SES and health lifestyles in adulthood persist even after controlling for adult SES. For men, lack of leisure-time physical activity and unhealthy food consumption largely explained the association between early-life disadvantage and MetS. For women, leisure-time physical activity partially accounted for the association, with the direct effect of childhood SES remaining significant. Evidence that material deprivation in early life compromises metabolic health in adulthood calls for policy attention to improve economic conditions for disadvantaged families with young children where behavioral pathways (including gender differences therein) may be shaped. The findings also underscore the need to develop gender-specific interventions in adulthood

High fidelity full sized human patient simulation manikins: Effects on decision making skills of nursing students

Background: The continued use of high fidelity full sized human patient simulation manikins (HF-HPSMs) for developing decision making skills of nursing students has led to growing research focusing its value on student learning and decision making skills. Methods: In October 2012, a cross-sectional survey using the 24-item Nurse Decision-Making Instrument was used to explore the decision making process of 232 pre-registration nursing students (age 22.0 + 5.4; 83.2% female) in Singapore. Results: The independent samples t-tests demonstrated three significant predictive indicators. These indicators include: prior experience in high fidelity simulation based on pre-enrolled nursing course (t = 70.6, p = .001), actual hands-on practice (t = 69.66, p < .005) and active participation in debrief (t = 70.11, p < .005). A complete experience based on role-playing followed by active discussion in debrief was a significant contributor to the decision making process (t = 73.6667, p < .005). However, the regression model indicated active participation in debrief as a significant variable which explained its development (t = 12.633, p < .005). Conclusions: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active participation in debrief was a more important influencing element than role-playing. In situations where resources are limited for students to experience hands-on role-playing, peer reviewing and feedback on others’ experiences could benefit students, just as much. However, further study is warranted to determine the development of HF-HPSMs as a pedagogic tool for enhancing the decision making process of nursing students

Biochemical Properties of a Decoy Oligodeoxynucleotide Inhibitor of STAT3 Transcription Factor.

Cyclic STAT3 decoy (CS3D) is a second-generation, double-stranded oligodeoxynucleotide (ODN) that mimics a genomic response element for signal transducer and activator of transcription 3 (STAT3), an oncogenic transcription factor. CS3D competitively inhibits STAT3 binding to target gene promoters, resulting in decreased expression of proteins that promote cellular proliferation and survival. Previous studies have demonstrated antitumor activity of CS3D in preclinical models of solid tumors. However, prior to entering human clinical trials, the efficiency of generating the CS3D molecule and its stability in biological fluids should be determined. CS3D is synthesized as a single-stranded ODN and must have its free ends ligated to generate the final cyclic form. In this study, we report a ligation efficiency of nearly 95 percent. The ligated CS3D demonstrated a half-life of 7.9 h in human serum, indicating adequate stability for intravenous delivery. These results provide requisite biochemical characterization of CS3D that will inform upcoming clinical trials

A quasi-experiment to evaluate the effects of a blended approach of simulation learning and podcasting on caring behaviours

Background: The need for quality nursing personnel in clinical practice expected nurse teachers to be able to impart instrumental and expressive aspects of caring behaviours to nursing students. Operating in a resource-limited higher educational context, nurse teachers are required to do so in a cost effective way. This study as part of a larger study evaluated the effects of a blended approach to learning of caring behaviours based on ‘modified’ medium-fidelity simulation scenarios and podcasting to repeat debriefs. Methods: This study employed a quasi-experimental, two group pre-test-post-test design. The study included 146 second year nursing students. Participants were divided into ‘intervention’ and ‘control’ groups and were asked to complete a caring behaviour inventory scale at various stages of the research study. Results: Students in the intervention group scored statistically higher, post receiving medium-fidelity simulation learning and higher post podcasting. The exposure to high fidelity simulation learning has resulted in the lower scoring in control group. Conclusions: This study highlights the value of a blended approach based on medium-fidelity simulation learning and podcasting. Successful learning of caring behaviours lies in the heart of a care-oriented teaching approach rather than the use of sophisticated technologies. This study has implications for a better practice in nursing education for developing student caring behaviours, it also has a wider implication for all vocational and non-nursing healthcare education