Newly graduated nurses' experiences of a trainee programme regarding the introduction process and leadership in a hospital setting-A qualitative interview study.

AIM AND OBJECTIVES: This study aimed to describe newly graduated nurses' experiences of introduction processes and leadership within a hospital trainee programme. BACKGROUND: For many, being a newly graduated nurse is associated with stress, influenced by the challenge of the transition to independent nurse, coupled with the loss of mentorship due to nurse turnover and rapidly changing demands. METHODS: A qualitative design with an inductive approach was chosen, and four focus groups were convened. A total of nineteen nurses were included in the study. Data were analysed using qualitative content analysis. COREQ was used as EQUATOR checklist. FINDINGS: The analysis resulted in three themes: Need for an introduction when facing a complex reality, Striving to stand on my own and The importance of having an accessible and multiskilled manager. The transition is a complex, dynamic and demanding process. CONCLUSIONS: The orientation process from student to becoming an independent nurse is a challenging period. A flexible manager and a readily accessible leadership facilitate the newly graduated nurse's striving to become an independent nurse. The study demonstrates that a trainee programme and support are essential in this process. There are indications that today's newly graduated nurses have high expectations of coaching from the manager during the orientation process. RELEVANCE TO CLINICAL PRACTICE: The hospital setting and its organisation are rapidly changing in relation to the increasing number of patients and their health status. In addition, there is a need for newly graduated nurses to secure regrowth, to fill the ranks of experienced nurses leaving the field. Newly graduated nurses increasingly perceive a gap between their training and clinical realities, thus necessitating changes in tutoring and their introduction to the work.

Structures of Two Melanoma-Associated Antigens Suggest Allosteric Regulation of Effector Binding.

The MAGE (melanoma associated antigen) protein family are tumour-associated proteins normally present only in reproductive tissues such as germ cells of the testis. The human genome encodes over 60 MAGE genes of which one class (containing MAGE-A3 and MAGE-A4) are exclusively expressed in tumours, making them an attractive target for the development of targeted and immunotherapeutic cancer treatments. Some MAGE proteins are thought to play an active role in driving cancer, modulating the activity of E3 ubiquitin ligases on targets related to apoptosis. Here we determined the crystal structures of MAGE-A3 and MAGE-A4. Both proteins crystallized with a terminal peptide bound in a deep cleft between two tandem-arranged winged helix domains. MAGE-A3 (but not MAGE-A4), is predominantly dimeric in solution. Comparison of MAGE-A3 and MAGE-A3 with a structure of an effector-bound MAGE-G1 suggests that a major conformational rearrangement is required for binding, and that this conformational plasticity may be targeted by allosteric binders.