Enhancing Nurses' Oral Therapy Practice in 4 Latin American Countries: A Collaborative and Participatory Approach.

BACKGROUND: Oral therapy (OT) use for cancer is increasing globally. Yet, nurses in 4 Latin American countries lacked knowledge and educational opportunities to safely care for people receiving OTs. Global partnerships to contextualize education and create local capacity may enhance nursing practice. OBJECTIVE: Within 4 Latin American countries, this study aims to (1) develop, deliver, and evaluate an OT cancer nursing education program and (2) evaluate the feasibility and efficacy of using an integrated knowledge translation (iKT) framework to develop the program and foster nurses' capacity for OT care. METHODS: Using the iKT framework, a "train the trainer" model was used to develop, contextualize, pilot test, implement, and evaluate the OT education program. An online survey evaluated nurses' perceived benefits, ease of use, barriers, facilitators, and recommendations for improvement. Nurses' self-reported OT practices were evaluated 9 months after the final workshop. RESULTS: One hundred nineteen nurses across 4 countries participated in a pilot and/or final OT educational workshop, facilitated by 6 local nurse champions. The nurse champions found the program easy to use and modify. Participants reported using the curriculum to teach other nurses and patients and networking opportunities for problem solving. Barriers included nurses' role clarity and time for education. CONCLUSIONS: The iKT approach was an effective method to develop the OT curriculum and build OT capacity among nurses and leaders within the 4 countries. IMPLICATIONS FOR PRACTICE: The iKT approach may be useful in low- or middle-income countries to enhance nursing education and practice. Future OT education projects should strengthen strategies for ongoing support after education intervention.

Effects of the beta-amino acid antagonist TAG on thalamocortical inhibition.

Chemical transmission at inhibitory synapses in thalamus may involve receptor activation by beta-amino acids and glycine, as well as GABA. Given their hypothesized roles, we investigated effects of the putative beta-amino acid antagonist 6-aminomethyl-3-methyl-4H-1,2,4-benzothiadiazine-1,1-dioxide (TAG) on synaptic inhibition in dorsal thalamus. We performed whole-cell recordings in 200-250 microm sections and immunocytochemical (ICC) studies in ventrobasal thalamus of rat brain (P12-P14). Stimulation of medial lemniscus evoked inhibitory postsynaptic currents (IPSCs) which were purely glycinergic or GABA(A)ergic, or most commonly mixed glycinergic and GABA(A)ergic responses, based on abolition by strychnine, bicuculline, or combined antagonism. TAG antagonized mixed IPSCs (IC(50) approximately 70 microM) in a manner distinguishable from classical glycine and GABA(A) receptor antagonists. TAG (250 microM) reduced the amplitude of glycinergic components which had a decay time constant of approximately 9 ms or approximately 230 ms by 45-50%, and a GABA(A)ergic component which had a decay time constant of approximately 40 ms by approximately 60%. As in the glycinergic component, TAG reduced the amplitude of infrequently occurring, pure glycinergic IPSCs. Surprisingly, TAG had no effect on pure GABA(A)ergic IPSCs, with a decay time constant of approximately 20 ms that correlated to kinetics of GABA-activated channels. ICC studies showed co-localization of alpha(1/2) glycine and alpha(4) GABA(A) receptors at inhibitory synapses. Activation of alpha(4) receptors by beta-amino acids may contribute to the GABA(A)ergic component of mixed IPSCs. The short and long-duration glycinergic IPSCs had decay time constants that correlated to the burst durations of single channels opened by beta-amino acids and glycine. Overall, the effects of TAG implicate beta-amino acid involvement in GABA(A)ergic and glycinergic transmission.