Supporting minority nursing students: 'Opportunity for Success' for Ethiopian immigrants in Israel.

AIM: To report on an Israeli academic nursing project, aimed at supporting the integration of Ethiopian immigrants into nursing studies. BACKGROUND: The representation of ethnic minorities within nursing is crucial for the provision of efficient care in diverse societies. Nevertheless, successful integration of minority students in nursing programs is not a simple task and needs developing support systems that will attract and retain students from minorities. Ethiopian Jewish immigrants and their descendants in Israel form a community of 120,000 people. Their participation in the national workforce is low, as well as their average income. METHODS: The paper is based on formative evaluation, using action research, of an academic nursing program in Israel. FINDINGS: Four main strategies identify this project: (1) a policy of institutional commitment, (2) personal relations with staff, (3) personal tutoring, and (4) cultural safety education. The project has reached success in terms of attraction, retention and students' satisfactions. The project's two main challenges, which need further concern, are: (1) giving support without labelling and (2) supporting without creating dependency. CONCLUSIONS AND INTERNATIONAL POLICY IMPLICATIONS: Appropriate strategies can enable success of minority students. Nevertheless, the amount of support needed for such programs raises two major questions: (1) To what extent should individual nursing departments be expected to bear solutions to this widely experienced problem? (2) How does focusing on one minority affect cultural safety of the overall group?

Challenges on the path to cultural safety in nursing education.

AIM: The purpose of this study is to identify central challenges to be addressed in cultural safety education. BACKGROUND: In recent years, the idea of cultural safety has received increased attention as a way of dealing with diversity in the nursing profession, especially in divided societies. The idea of cultural safety goes beyond recognizing and appreciating difference, to an attempt to grappling with deeper issues like inequality, conflict and histories of oppression. METHODS: The paper is based on formative evaluation, using action research, of an academic nursing programme in Israel, involving Jewish and Arab students. Part of this research dealt with the integration of cultural safety education into the curriculum. FINDINGS: The study revealed four challenges in cultural safety education: making it safe for minorities to present their culture to the majority group ('the ambassador's dilemma'), dealing with tendency of groups to deny the existence of conflict ('the one big happy family fantasy'), making dynamics of oppression discussable ('the oppressed and the oppressor') and creating conditions in which people can freely choose their individual and group identities ('the threat of identity'). CONCLUSION: Cultural safety education may be experienced as unsafe for many participants. Better understanding of the challenges of cultural safety education is necessary for making it more effective.

Teaching nursing in a situation of conflict: encounters between Palestinian-Israeli and Jewish-Israeli nursing students.

PURPOSE: This research examines the ways Palestinian-Israeli and Jewish-Israeli nursing students, who study together in one group in an academic school of nursing situated in northern Israel, perceive each other and the relationships among them. DESIGN: The study is based on semi-structured interviews with undergraduate students. The cohort consists of 46 students, 20 of whom participated in the study. FINDINGS: The students perceive themselves as divided into two separate groups according to nationality. Cooperation between the groups related to their study duties is described as generally satisfying, but little expressive communication and scarce social relations occur across these two groups. Students provided their perceptions of 'the others' to explain this social distance. IMPLICATIONS: We discuss the challenges of the situation for nursing educators and some strategies for coping with these challenges.

The establishment of an academic nursing faculty: action research in Israel.

AIM: The aim of this paper is twofold: to conceptualize tensions related to the academization of nursing, and to analyse a case study, describing how such tensions were dealt with in the process of establishing a new nursing department. BACKGROUND: This paper represents the first stage of a case study of the transformation of a hospital-based nursing school into an academic programme, carried out as a joint venture between a local hospital school and a college in northern Israel. METHODS: This paper is based on action research. The participants were 19 members of the new academic faculty and 3 members of an action research center. FINDINGS: The three inter-related tensions surfaced in the research process are: (1) the status of nursing and nurses, (2) the role of research and critical thinking in nursing education and practice, and (3) the characteristics of students, who should enroll in and graduate from nursing programmes, or in other words, the character of the 'ideal nurse'. CONCLUSIONS: An action research process enables new teams to put tensions on the table so they can be openly addressed through ongoing reflection, inquiry, learning, evaluation and redesign.

The academization of nursing: implications for Arab enrolled nurses in Israel.

BACKGROUND: The trend towards the abolition of second level (practical) nurse education, begun decades ago in Western countries, is being adopted in Israel. In 2004 practical (enrolled) nurses constituted approximately one-third of the Israeli nursing labour force, many of whom were Arab-Israelis. Practical nurses in Israel are now expected to upgrade their education to fi rst (registered) level nurse. AIM: To understand the current situation of Arab-Israeli practical nurses, taking into account the cultural, ethnic, socio-economic and gender aspects of their lives. METHODS: A qualitative, ethnographic approach, using in-depth interviews with 13 Arab-Israeli nurses. FINDINGS: The women's negative attitudes to the conversion course were not related to their otherwise positive attitudes to education in general. The conversion course was affected by adverse material conditions; cultural factors and feeling of helplessness. The threat of loss of professional nursing status as a result of the changes in nursing gave rise to a great sense of personal loss. CONCLUSION: As reported in other countries, the academization of nursing in Israel is obstructing one of the major routes of social mobility for women in the weaker sections of society. This situation is experienced as particularly harsh, because of the overall oppressive situation that Arab women in Israel suffer.

Spin distribution and the location of protons in paramagnetic proteins.

Two current frontiers in EPR research are high-field ( nu0 > 70 GHz, B0 > 2.5 T ) electron paramagnetic resonance (EPR) and high-field electron-nuclear double resonance (ENDOR). This review focuses on recent advances in high-field ENDOR and its applications to the study of proteins containing native paramagnetic sites. It concentrates on two aspects; the first concerns the determination of the location of protons and is related to the site geometry, and the second focuses on the spin density distribution within the site, which is inherent to the electronic structure. Both spin density and proton locations can be derived from ligand hyperfine couplings determined by ENDOR measurements. A brief description of the experimental methods is presented along with a discussion of the advantages and disadvantages of high-field ENDOR compared with conventional X-band (~ 9.5 GHz) experiments. Specific examples of both protein single crystals and frozen solutions are then presented. These include the determination of the coordinates of water ligand protons in the Mn(II) site of concanavalin A, the detection of hydrogen bonds in a quinone radical in the bacterial photosynthetic reaction center as well as in the tyrosyl radical in ribonuclease reductase, and the study of the spin distribution in copper proteins. The copper proteins discussed are the type I copper of azurin and the binuclear CuA center in a number of proteins. The last part of the review presents a brief discussion of the interpretation of hyperfine couplings using quantum chemical calculations, primarily density functional theory (DFT) methods. Such methods are becoming an integral part of the data analysis tools, as they can facilitate signal assignment and provide the ultimate relation between the experimental hyperfine couplings and the electronic wave function.

New synthesis and insight into the structure of blue ultramarine pigments.

A new and easy method for preparing blue sodalite pigments which involves high-temperature calcination of sodalite samples synthesized with aluminum sulfate and an organic template, is presented. Calcination generated the S(3)(-) and S(2)(-) radicals, and the effects of the Al/Si ratio and the calcination temperature on the nature and amounts of the radicals were examined. The radicals were characterized in detail by continuous wave and pulsed EPR at X- and W-band frequencies (approximately 9 and 95 GHz, respectively) complemented by UV-vis measurements. The high-field electron-paramagnetic resonance (EPR) measurements allowed us to clearly resolve the g anisotropy of S(3)(-) and W-band electron nuclear double resonance (ENDOR) measurements detected strong coupling with extra-framework (23)Na cations and weak coupling with framework (27)Al. On the basis of the spectroscopic results and density functional theory (DFT) calculations of the g-tensors of S(3)(-) and S(2)(-) radicals, the EPR signals were attributed to three different radicals, all with the open structure C(2v), that are located within the sodalite beta cages. While two of these radicals are well isolated, the third one is associated with an exchange-narrowed signal originating from S(3)(-) radicals in nearby sodalite cages.

Improving W-band pulsed ENDOR sensitivity--random acquisition and pulsed special TRIPLE.

Two approaches for improving the signal-to-noise ratio (S/N) of W-band pulsed electron-nuclear double resonance (ENDOR) spectra are presented. One eliminates base-line problems while the other enhances the ENDOR effect. High field ENDOR spectra measured at low temperatures often suffer from highly distorted base-lines due to the heating effect of the RF pulses that causes some detuning of the cavity and therefore leads to a reduction in the echo intensity. This is a severe problem because it often masks broad and weak ENDOR signals. We show that it can be eliminated by recording the ENDOR spectrum in a random, rather than the standard sequential variation of the RF frequency. The S/N of the ENDOR spectrum can be significantly enhanced by the application of the pulse analog of the continuous wave (CW) special TRIPLE experiment. While this experiment is not applicable in the solid state at conventional X-band frequencies, at W-band it is most efficient. We demonstrate the efficiency of the special TRIPLE Davies and Mims experiments on single crystals and orientationally disordered systems.

Warfarin skin necrosis: local and systemic factors.

Warfarin induced skin necrosis occurs in 0.01-0.1% of warfarin treated patients. The usual presentation is that of painful lesions developing in obese women after the initiation of warfarin treatment. The lesions usually evolve into full thickness skin necrosis within a few days. Although the exact mechanism is not totally clear, low levels of Protein C or S, either functional or inherited, are associated with many of the cases. We report the case of a 17-year-old patient treated with warfarin because of iliofemoral deep vein thrombosis post abortion. The patient developed several huge haemorrhagic blisters on the affected leg. The condition rapidly developed into full thickness skin and fat necrosis. The necrotic lesions were excised and eventually covered with skin graft. The combination of the patient tendency towards hyper-coagulation and the local factors is discussed.

A W-band pulsed ENDOR spectrometer: setup and application to transition metal centers.

The design and performance of a 95 GHz pulsed W-band EPR/ENDOR spectrometer is described with emphasis on the ENDOR part. Its unique feature is the easy and fast sample exchange at 4.2 K for frozen solution and single crystal samples. In addition, the microwave bridge power output is relatively high (maximum 267 mW), which allows the application of short microwave pulses. This increases the sensitivity in echo experiments because of the broader excitation bandwidth and the possibility of employing short pulse intervals, as long as the dead time does not increase significantly with the power. The spectrometer features two microwave and radiofrequency (0.1-220 MHz, 3 kW pulse power) channels and a 6 T superconducting magnet in a solenoid configuration. The magnet is equipped with cryogenic sweep coils providing a sweep range of +/-0. 4 and +/-0.2 T for a center field of 0-4 and 4-6 T, respectively. The spectrometer performance is demonstrated on Cu(II) centers in single crystals, a zeolite polycrystalline sample, and a protein frozen solution.