Development and psychometric testing of an instrument to compare career choice influences and perceptions of nursing among healthcare students

Background: With the availability of more healthcare courses and an increased intake of nursing students, education institutions are facing challenges to attract school leavers to enter nursing courses. The comparison of career choice influences and perception of nursing among healthcare students can provide information for recruitment strategies. An instrument to compare the influences of healthcare career choice is lacking. The purpose of this study is to develop and evaluate the psychometric properties of an instrument to compare the influences of healthcare career choice with perceptions of nursing as a career choice. Methods: The study was conducted in two phases. In phase one, two sets of scales with parallel items that measure the influences of healthcare career choice and perceptions of nursing as a career choice were developed through an earlier qualitative study, literature review, and expert validation. Phase two involved testing the construct validity, concurrent validity and reliability with a convenience sample of 283 first year healthcare students who were recruited at two education institutions in Singapore. Results: An exploratory factor analysis revealed 35-parallel items in a six-factor solution (personal interest, prior healthcare exposure, self-efficacy, perceived nature of work, job prospects, and social influences) that explained 59 and 64% of the variance for healthcare career choice and nursing as a career choice respectively. A high correlation (r = 0.76, p \u3c 0.001) was obtained with an existing tool, confirming the concurrent validity. The internal consistency was sufficient with Cronbach’s alpha of 0.93 for healthcare career choice and 0.94 for nursing as a career choice. The test-retest reliability was acceptable with an Intraclass Correlation Coefficient of 0.63 for healthcare career choice and 0.60 for nursing as a career choice. Conclusions: The instrument provides opportunities for understanding the differences between influences of healthcare career choice and perceptions of nursing as a career choice. This comparative understanding of career choice influences can guide educator and policy-makers on nursing recruitmen

BAFF Promotes Th17 Cells and Aggravates Experimental Autoimmune Encephalomyelitis

BAFF, in addition to promoting B cell survival and differentiation, may affect T cells. The objective of this study was to determine the effect of BAFF on Th17 cell generation and its ramifications for the Th17 cell-driven disease, EAE.Th17 cells were increased in BAFF-Tg B6 (B6.BTg) mice and decreased in B6.Baff(-/-) mice. Th17 cells in B6.Baff(-/-) mice bearing a BAFF Tg (B6.Baff(-/-).BTg mice) were identical to those in B6.BTg mice, indicating that membrane BAFF is dispensable for Th17 cell generation as long as soluble BAFF is plentiful. In T + non-T cell criss-cross co-cultures, Th17 cell generation was greatest in cultures containing B6.BTg T cells and lowest in cultures containing B6.Baff(-/-) T cells, regardless of the source of non-T cells. In cultures containing only T cells, Th17 cell generation followed an identical pattern. CD4(+) cell expression of CD126 (IL-6R α chain) was increased in B6.BTg mice and decreased in B6.Baff(-/-) mice, and activation of STAT3 following stimulation with IL-6 + TGF-β was also greatest in B6.BTg cells and lowest in B6.Baff(-/-) cells. EAE was clinically and pathologically most severe in B6.BTg mice and least severe in B6.Baff(-/-) mice and correlated with MOG(35-55) peptide-induced Th17 cell responses.Collectively, these findings document a contribution of BAFF to pathogenic Th17 cell responses and suggest that BAFF antagonism may be efficacious in Th17 cell-driven diseases

Defining the Critical Hurdles in Cancer Immunotherapy

ABSTRACT: Scientific discoveries that provide strong evidence of antitumor effects in preclinical models often encounter significant delays before being tested in patients with cancer. While some of these delays have a scientific basis, others do not. We need to do better. Innovative strategies need to move into early stage clinical trials as quickly as it is safe, and if successful, these therapies should efficiently obtain regulatory approval and widespread clinical application. In late 2009 and 2010 the Society for Immunotherapy of Cancer (SITC), convened an "Immunotherapy Summit" with representatives from immunotherapy organizations representing Europe, Japan, China and North America to discuss collaborations to improve development and delivery of cancer immunotherapy. One of the concepts raised by SITC and defined as critical by all parties was the need to identify hurdles that impede effective translation of cancer immunotherapy. With consensus on these hurdles, international working groups could be developed to make recommendations vetted by the participating organizations. These recommendations could then be considered by regulatory bodies, governmental and private funding agencies, pharmaceutical companies and academic institutions to facilitate changes necessary to accelerate clinical translation of novel immune-based cancer therapies. The critical hurdles identified by representatives of the collaborating organizations, now organized as the World Immunotherapy Council, are presented and discussed in this report. Some of the identified hurdles impede all investigators, others hinder investigators only in certain regions or institutions or are more relevant to specific types of immunotherapy or first-in-humans studies. Each of these hurdles can significantly delay clinical translation of promising advances in immunotherapy yet be overcome to improve outcomes of patients with cancer

Knowledge, attitude and practice concerning healthcare-associated infections among healthcare workers in Wuhan, China: Cross-sectional study

10.1136/bmjopen-2020-042333BMJ Open111e042333

Health-Related Quality of Life in Predominantly Young Parental Living Liver Donors: A Cross-Sectional Study in China

10.3389/fmed.2021.726103Frontiers in Medicine8726103

Parental experiences while waiting for children undergoing surgery in Singapore

Abstract Purpose: To explore the experiences and needs of parents while waiting for their children undergoing surgery. Designs and methods: A descriptive qualitative study was conducted. A purposive sample of 11 parents who went through their first waiting experiences during their children‘s surgeries in a Singapore public hospital was recruited. Children younger than or equal to 16 years of age were included. A semi-structured interview guide facilitated the individual face-to-face interviews. Thematic analysis was used. Results: Four themes were identified: “Care and care provision affecting waiting experiences”, “Parental concerns and surgery affecting waiting experiences”, “Coping strategies used during waiting periods” and “Recommendations to improve waiting experiences”. Pre-operative instructions, the professionalism of medical teams, and a lack of timely updates affected parental experiences. Parents expressed their worries. The complexities and types of surgery influenced how they felt. Their concerns included potential complications, surgical outcomes, anesthesia-related side effects, and post-operative care including pain. They spent their waiting times eating, resting, using their smart devices, and coping with a support system. Environmental improvements, more updates, and mobile applications were recommended by the participants. Conclusion: For a parent, the wait during his/her child‘s surgery can be unsettling. Our results give insights into parental waiting experiences and needs during their children‘s surgeries. Practice implications: These findings can guide the improvement of the current practise based on our evidence or the implementation of newer technology to provide better waiting experiences for parents during their children‘s surgeries and to enhance the quality of clients‘ experiences in the hospital

A qualitative study exploring Singaporean parents’ perceptions on preparing their child for surgery

Abstract Purpose: To explore the perceptions of parents regarding the preparation of their children for surgery. Design and methods: A qualitative descriptive study was conducted. Sixteen parents of children who were undergoing various types of elective surgery in a public tertiary hospital in Singapore were recruited. Data were collected through face-to-face interviews and analyzed using thematic analysis. Results: Five themes were derived: (1) assumed roles of the parents; (2) communication, decision-making, and emotional challenges; (3) factors facilitating the preparation of children for surgery; (4) surgery-related and financial concerns; and (5) the desire for more information and better management. While preparing their children for surgery, parents undertook several roles to ensure readiness and to provide support. Parents faced challenges while communicating with their children regarding their surgeries, experiencing negative emotions and dilemmas in making decisions for surgery. Factors such as previous experiences, children’s positive mentality, and access to information helped to facilitate their preparation. Parents expressed surgery-related concerns such as anesthesia and a successful outcome of the surgery, the timing of the surgery, and postoperative care. Parents expressed a desire for easier to understand information through the use of visual materials, and improvements in current practices and management. Conclusion: This study provides a greater understanding of parents’ perceptions of their roles, challenges, influencing factors, concerns, and needs when preparing their children for surgery. Practice implications: The study findings provide insightful aspects for improving current healthcare practices and informing future research studies in exploring better surgery preparation programs for both parents and children