ABSTRACT
AIM: The aim was to explore how nurse mentors experience the assessment of nursing students in clinical placements at hospitals and in municipal health care. DESIGN: The study is qualitative with an explorative and descriptive design. METHODS: Based on an interview guide, we conducted 19 individual qualitative interviews and four focus group interviews with nurse mentors from various levels and fields of nursing education at a Norwegian university. RESULTS: Feedback in and on action was an integrated part of the formative assessment. In the summative assessment, where the university lecturer also participates, the nurse mentors perceived their role as passive. A disturbing finding was that divergent views on the student's competence sometimes occurred in these situations, thus challenging the credibility of the student assessment. Perceptions of nursing values and concerns embedded in nursing practice as collective criteria appear to have an impact on the mentors' assessment of the nursing students.
Subject(s)
Education, Nursing, Baccalaureate , Education, Nursing , Students, Nursing , Humans , Mentors , PerceptionABSTRACT
Patients with melanoma have a high risk of developing brain metastasis, which is associated with a dismal prognosis. During early stages of metastasis development, the blood-brain barrier (BBB) is likely intact, which inhibits sufficient drug delivery into the metastatic lesions. We investigated the ability of the peptide, K16ApoE, to permeabilize the BBB for improved treatment with targeted therapies preclinically. Dynamic contrast enhanced MRI (DCE-MRI) was carried out on NOD/SCID mice to study the therapeutic window of peptide-mediated BBB permeabilization. Further, both in vivo and in vitro assays were used to determine K16ApoE toxicity and to obtain mechanistic insight into its action on the BBB. The therapeutic impact of K16ApoE on metastases was evaluated combined with the mitogen-activated protein kinase pathway inhibitor dabrafenib, targeting BRAF mutated melanoma cells, which is otherwise known not to cross the intact BBB. Our results from the DCE-MRI experiments showed effective K16ApoE-mediated BBB permeabilization lasting for up to 1 hour. Mechanistic studies showed a dose-dependent effect of K16ApoE caused by induction of endocytosis. At concentrations above IC50, the peptide additionally showed nonspecific disturbances on plasma membranes. Combined treatment with K16ApoE and dabrafenib reduced the brain metastatic burden in mice and increased animal survival, and PET/CT showed that the peptide also facilitated the delivery of compounds with molecular weights as large as 150 kDa into the brain. To conclude, we demonstrate a transient permeabilization of the BBB, caused by K16ApoE, that facilitates enhanced drug delivery into the brain. This improves the efficacy of drugs that otherwise do not cross the intact BBB.
Subject(s)
Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Imidazoles/administration & dosage , Melanoma/drug therapy , Oximes/administration & dosage , Peptides/administration & dosage , Animals , Blood-Brain Barrier/chemistry , Brain Neoplasms/genetics , Cell Line, Tumor , Dogs , Dose-Response Relationship, Drug , Endocytosis , Humans , Imidazoles/pharmacokinetics , Madin Darby Canine Kidney Cells , Melanoma/genetics , Mice , Mutation , Oximes/pharmacokinetics , Peptides/pharmacokinetics , Proto-Oncogene Proteins B-raf/genetics , Rats , Xenograft Model Antitumor AssaysABSTRACT
PURPOSE: The aim of this study was to describe patient satisfaction with nursing care in three different Norwegian Coronary Intensive Care Units and compare the results with other structural factors such as nursing competence, skill-mix, clinical experience, nurse to patient ratio and number of beds. METHODS: A descriptive and comparative design was employed and 150 patients at three Coronary Intensive Care Units were included. Patient satisfaction data was collected using the Intensive Nursing Care Quality Instrument (59 items). The data collected was comprised of two parts: a questionnaire and information on the structural factors of the organisational structure. The data was analysed using descriptive statistics. RESULTS: Patients expressed overall satisfaction with the nursing care. No clear association was found between patient satisfaction and nursing competence, skill-mix, clinical experience, nurse to patient ratio and number of beds. When comparing results between units, significant differences were seen for 17 out of 46 questions. CONCLUSIONS: The results provide insight into how critical care staffing and skill-mix affect patient satisfaction and guide future nursing research in this subject area.
