Career Preferences among Nursing Students: A Cross-Sessional Study.

Introduction: It is estimated that mores nurses are needed in the future, nursing students' career preferences are important to contribute the shortage of nursing manpower in Macao. Little is known regarding the preferences for nursing students' career preferences and related factors among nursing students. Objective: To explore and investigate the career preferences and related factors among nursing students in Macao. Methods: A descriptive, cross-sectional survey study design was adopted to assess career preferences and related factors among nursing students in Macao. Results: In total, 217 nursing students completed surveys. The most favorite career preferences among nursing students were community health nursing, paediatric nursing, medical surgical nursing, and obstetric & gynecological nursing; while the least career preferences among nursing students were oncology and hospice nursing, mental health nursing, and ER nursing. Factors were related to "gender", "education", and "nursing is my first study preference" among Macao nursing students for career preferences. Conclusion: The senior nursing students prefer working in community health nursing and the junior and female nursing students prefer working in pediatric nursing and obstetric and gynecological nursing. The more understandings of nursing students' career preferences, the better nursing curriculum design and implication to promote nursing students' intention for working in the least career preferences work.

Fiber degradation potential of natural co-cultures of Neocallimastix frontalis and Methanobrevibacter ruminantium isolated from yaks (Bos grunniens) grazing on the Qinghai Tibetan Plateau.

Several natural anaerobic fungus-methanogen co-cultures have been isolated from rumen and feces source of herbivores with strong fiber degrading ability. In this study, we isolated 7 Neocallimastix with methanogen co-cultures from the rumen of yaks grazing on the Qinghai Tibetan Plateau. Based on morphological characteristics and internal transcribed spacer 1 sequences (ITS1), all the fungi were identified as Neocallimastix frontalis. The co-cultures were confirmed as the one fungus - one methanogen pattern by the PCR-denatured gradient gel electrophoresis (DGGE) assay. All the methanogens were identified as Methanobrevibacter ruminantium by 16s rRNA gene sequencing. We investigated the biodegrading capacity of the co-culture (N. frontalis + M. ruminantium) Yaktz1 on wheat straw, corn stalk and rice straw in a 7 days-incubation. The in vitro dry matter digestibility (IVDMD), acid detergent fiber digestibility (ADFD) and neural detergent fiber digestibility (NDFD) values of the substrates in the co-culture were significantly higher than those in the mono-culture N. frontalis Yaktz1. The co-culture exhibited high polysaccharide hydrolase (xylanase and FPase) and esterase activities. The xylanase in the co-culture reached the highest activity of 12500 mU/ml on wheat straw at the day 3 of the incubation. At the end of the incubation, 3.00 mmol-3.29 mmol/g dry matter of methane were produced by the co-culture. The co-culture also produced high level of acetate (40.00 mM-45.98 mM) as the end-product during the biodegradation. Interestingly, the N. frontalis Yaktz1 mono-culture produced large amount of lactate (8.27 mM-11.60 mM) and ethanol (163.11 mM-242.14 mM), many times more than those recorded in the previously reported anaerobic fungi. Our data suggests that the (N. frontalis + M. ruminantium) Yaktz1 co-culture and the N. frontalis Yaktz1 mono-culture both have great potentials for different industrial use.

A systematic review of selected evidence on improving knowledge and skills through high-fidelity simulation.

A systematic review of the evidence published between 2000 and 2010 was undertaken using the following databases: CINAHL, ProQuest, MEDLINE, Science Direct, OVID and Chinese Academic Journal. Empirical studies determining the effects of high-fidelity simulation on knowledge and skills in nursing or medical education were considered. As a result, nine English and seventeen Chinese studies were retrieved. They included sixteen randomized controlled trails (RCTs), one nonrandomized-controlled trial, and nine quasi-experimental studies. The high-fidelity simulation did enhance the scores on knowledge and skill exams but its contribution to objective structured clinical evaluation is mixed. The majority of reviewed RCTs are of low methodological quality. It is necessary to conduct additional RCTs with larger sample sizes to determine whether performance can be enhanced by high-fidelity simulation.

Antimicrobial resistance, genotypic characterization and pulsed-field gel electrophoresis typing of extended spectrum ß-lactamases-producing clinical Escherichia coli strains in Macao, China.

BACKGROUND: The rise of the production of CTX-M class extended spectrum ß-lactamases (ESBLs) has been well documented in traveling countries but no data are found for Macao, an international travel city. The objectives of this study were to identify the antimicrobial resistance pattern, and determine the prevalence, genotype and clonal relationship of ESBLs in 209 clinical Escherichia coli strains from Macao, China. METHODS: Antimicrobial susceptibility test was performed to determine the resistance patterns of the isolates using the disk diffusion method with 17 antimicrobial agents. Phenotypic detection was screened and confirmed according to the Clinical and Laboratory Standards Institute. Genotypic characterization was detected by isoelectric focusing analysis, polymerase chain reaction and sequencing. The clonal relationship between the different ESBL isolates was studied by pulsed-field gel electrophoresis (PFGE). RESULTS: Imipenem and meropenem exhibited 100% susceptible among 209 strains. Overall, 82.3%, 67.3%, 52.9%, 51.2% and 51.0% of the isolates displayed resistance to ampicillin, tetracycline, ciprofloxacin, sulfamethoxazole trimethoprim and gentamycin. The prevalence rate of ESBLs was 30.1%. Antibiotic resistances were found to be significantly higher among the ESBL producing group compared to non-ESBL producing group. We detected CTX-M-14 to be the major genotypic characterization of ESBLs (76.2%). Two strains showed indistinguishable patterns by PFGE. CONCLUSIONS: The prevalence of antimicrobial resistance is alarming high in Macao. Antimicrobial resistance is significantly higher among the ESBL producing group. This study documented CTX-M-14 as the predominant ESBL type. Although indistinguishable pattern was found between two strains, it was too small to decide whether any of the investigated strains was epidemic. Our findings may be also pertinent for other geographic areas undergoing similar travel characteristics to understand the corresponding effects on bacterial populations.