Assessing continued competency through simulation: A call for stringent action.

This article proposes that simulation has potential as a method to validate critical and reflective thinking skills and continued competency of registered nurses. The authors recognize the challenges and benefits for using simulation in assessing competency. Furthermore, the authors stress that the potential use of simulation in competency testing cannot be achieved until educators and researchers acquire the specific knowledge and skills to make informed decisions and recommend policy.

Continued competency and board regulation: one state expands options.

State boards of nursing are mandated by state statutes to ensure the ongoing safe and competent practice of licensees. However, nursing practice is characterized by diversity in educational backgrounds, scope of practice, and variety of settings. As a result, regulatory agencies face many challenges.

Registered nurses select multiple factors associated with their errors.

Errors in health care are a leading cause of death and injury, requiring new methods for evaluating the efficacy of health care services. A board of nursing staff member conducted a study to examine perceptions of registered nurses who had been sanctioned for practice errors to ascertain the level of patient harm, and individual, health care team, patient, and system factors that contributed to the error or patient harm. Gaining the perspective of nurses who have been involved in a practice error can contribute to a better understanding of the factors involved in error commission.

Public policy on competency: how will nursing address this complex issue?

The evolving contexts in which nursing care is provided and the complexity of clients being served are raising new questions about the nature of nursing practice, the ways in which nurses can best be prepared for such practice settings, and how current staff can continually update their knowledge, skills, and abilities to provide competent care. It is imperative that the profession be forward looking as it reassesses the implications of assuring the public of a competent nursing work force. The mandate to prepare nurses differently to practice competently in future health care systems also suggests a different system for competency assessment.

Cardiac glycosides provide neuroprotection against ischemic stroke: discovery by a brain slice-based compound screening platform.

We report here the results of a chemical genetic screen using small molecules with known pharmacologies coupled with a cortical brain slice-based model for ischemic stroke. We identified a small-molecule compound not previously appreciated to have neuroprotective action in ischemic stroke, the cardiac glycoside neriifolin, and demonstrated that its properties in the brain slice assay included delayed therapeutic potential exceeding 6 h. Neriifolin is structurally related to the digitalis class of cardiac glycosides, and its putative target is the Na(+)/K(+)-ATPase.

Thought for application and application with thought: issues in theoretical thinking and practical wisdom.

Both theoretical thinking and practical wisdom are used by health professionals in their clinical practice. Lately, discussion has centered on the abstract phrase "theory-practice gap." The health profession is not the only discipline that seeks unity in theory and practice issues.

Lentiviral vector-based models of amyloid pathology: from cells to animals.

Lentiviral vectors are efficient tools for the introduction of genes into a wide range of established and primary cells in vitro, ex vivo, and in vivo, and also permit efficient transgenesis in a wide range of mammalian species. Our goals have been to apply the broad capabilities of the lentiviral vector system to AD research. Using a set of vectors expressing APP and PS1 genes, we demonstrated the efficiency and fidelity of the system for in vitro biochemical analyses of genes and pathways involved in plaque deposition.

Theoretical approaches for investigating patient safety.

Patient safety and freedom from accidental injury is an issue that is promoting the search for excellence among healthcare providers, payers, and consumers. The issue is complex and multifaceted, providing many avenues for analysis, quality enhancement, and research. Several models exist that may assist in exploring patient safety issues and the relationships between error and safety.

Inhibition of p53 by lentiviral mediated shRNA abrogates G1 arrest and apoptosis in retinal pigmented epithelial cell line.

We silenced p53 gene expression in ARPE-19, a human retinal pigmented epithelial cell line using RNA interference. The effect of silencing the p53 gene in proliferating ARPE-19 cells was studied. Four short hairpin RNAs (shRNAs) targeting different regions of human p53 mRNA were delivered individually into ARPE-19 cells using lentiviral vector to produce stable cell lines.

Novel approaches to models of Alzheimer's disease pathology for drug screening and development.

Development of therapeutics for Alzheimer's disease (AD) requires appropriate cell culture models that reflect the errant biochemical pathways and animal models that reflect the pathological hallmarks of the disease as well as the clinical manifestations. In the past two decades AD research has benefited significantly from the use of genetically engineered cell lines expressing components of the amyloid-generating pathway, as well as from the study of transgenic mice that develop the pathological hallmarks of the disease, mainly neuritic plaques. The choice of certain cell types and the choice of mouse as the model organism have been mandated by the feasibility of introduction and expression of foreign genes into these model systems.

Ultrastructure of the calcium-sequestering gastrodermal cell in the hydroid Hydractinia symbiolongicarpus (Cnidaria, Hydrozoa).

Large, free-floating crystals of calcium carbonate occur in vacuoles of gastrodermal cells of the hydroid Hydractinia symbiolongicarpus. Here, morphological details about the process by which these cells accumulate and sequester calcium are provided by a cytochemical method designed to demonstrate calcium at the ultrastructural level. Electron-dense material presumably indicative of the presence of calcium was EGTA-sensitive and was shown by parallel electron energy loss spectroscopy (EELS) and energy spectroscopic imaging (ESI) to contain calcium.

Regulatory compliance issues in behavioral health.

Behavioral health as a discipline has grappled with regulatory compliance issues on its own, tending to be isolated from other specialties and to benefit little from the mistakes and solutions of the rest of medicine. The most common problems with behavioral health regulatory compliance have to do with documentation, billing and coding, treatment plans, and medical necessity. Regulatory compliance is inextricably linked to quality of care.

Palliative care: rapid redesign to support systemwide quality improvement.

Large-scale change techniques and rapid redesign methodologies were used to improve the quality of care delivered to patients at the end of life in a large, multihospital healthcare delivery system. By bringing key stakeholders from across the system together at a symposium to formulate the vision and critical criteria for palliative care programs, as well as to develop a flexible set of design tools, each region in the system could respond to the unique needs of its own community. Hospice length of stay for the system improved by 100% in the year after the systemwide symposium.

Catecholamines induce metamorphosis in the hydrozoan Halocordyle disticha but not in Hydractinia echinata.

Planula larvae of the marine hydroids Halocordyle disticha and Hydractinia echinata were treated with the catecholamines epinephrine, norepinephrine and dopamine, as well as with certain of their precursors and agonists. Norepinephrine, L-dopa, dopamine and the dopamine agonist ADTN at concentrations ranging from 0.1 to 0.

Nerve elements in the planula of the hydrozoan Pennaria tiarella.

The nerve elements described by light microscopy for the hydrozoan planula have not previously been identified ultrastructurally. This electron microscopic study confirms the presence of two distinct nerve cell types in the planula of the hydroid Pennaria tiarella. Type I nerve cells occur at the base of the ectodermal epithelium just apical to the forming foot processes of the epitheliomuscle cells.