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The National Council of State Boards of Nursing plans to update the National Council Licensure Exam for nursing graduates to better measure clinical judgment. It is important that schools of nursing provide opportunities for nursing students to practice and develop clinical judgment skills. Simulation offers nursing students opportunities to use clinical reasoning and clinical judgment to care for patients in a safe environment The purpose of this study was to evaluate an unfolding case study using high-fidelity simulation to develop nursing students' clinical judgment skills across three practice settings: primary care office, acute care hospital, and home healthcare. This was a mixed-method, posttest study design with a convenience sample of 91 nursing students using the Lasater Clinical Judgment Rubric (LCJR) and survey questions. The posttest analysis mean of the LCJR subgroups revealed students felt accomplished following the intervention. Four themes emerged from content analysis of the qualitative data: 1.) increased knowledge of management of diabetes in various clinical settings, 2.) using clinical judgment/critical thinking in the home care setting, 3.) being able to self-reflect on actions, and 4.) a desire for more simulation experiences in the home healthcare setting. The results of the LCJR indicated that students felt accomplished after the simulation experience. This outcome was also evident in the qualitative data, indicating that students felt more confident in managing the care of a patient with a chronic illness using clinical judgment skills in various clinical settings.

This cross-sectional, comparative descriptive design study aimed to compare self-reports of perceived caring, measured by the Caring Behaviors Inventory-16 Student Version, in a convenience sample of undergraduate nursing students across three levels of the curriculum, second, third, and fourth years. The study evaluated their confidence in providing nursing care with a professional confidence Visual Analog Scale. Combined perceived caring and confidence scores increased on posttest and differed at a statistically significant level between pretest and posttest. Pretest and posttest perceived caring scores differed significantly among the three curriculum levels, for pretest confidence, but not for posttest senior level confidence. Convergent validity testing revealed a weak association between perceived caring and confidence in providing nursing care for patients. Cronbach’s alpha for the CBI-16 Student Version established beginning reliability. Perceived caring may be unintentionally part of a hidden curriculum through student experiences with patients, registered nurses, and faculty who model caring behaviors.

We have discovered a protein with an amino acid composition exceptionally rich in glycine and cysteine residues in the giant virus mimivirus. This small 6 kDa protein is among the most abundant proteins in the icosahedral 0.75 μm viral particles; it has no predicted function but is probably essential for infection. The aerobically purified red-brownish protein overproduced inEscherichia colicontained both iron and inorganic sulfide. UV/vis, EPR, and Mössbauer studies revealed that the viral protein, coined GciS, accommodated two distinct Fe-S clusters: a diamagnetic S= 0 [2Fe-2S]2+cluster and a paramagnetic S= 5/2 linear [3Fe-4S]1+cluster, a geometry rarely stabilized in native proteins. Orthologs of mimivirus GciS were identified within all clades of Megavirinae, a Mimiviridaesubfamily infecting Acanthamoeba, including the distantly related tupanviruses, and displayed the same spectroscopic features. Thus, these glycine/cysteine-rich proteins form a new family of viral Fe-S proteins sharing unique Fe-S cluster binding properties.

The ability to deliver culturally competent nursing care is an expected competency of undergraduate nursing education programs. The American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN) have developed toolkits that provide nurse educators with models and teaching strategies to facilitate student learning in cultural competency. However, the concept of cultural competency varies as does the best method for integrating and evaluating cultural competency in undergraduate nursing curriculum. With the growing number of diverse clients, it is imperative that nursing students deliver culturally competent care. This article explores the current view of the concept of cultural competency from the standpoint of nursing education and the methods used to evaluate cultural competency in undergraduate nursing education programs.

Valuable metals as well as ferrous iron and sulfur compounds are released from ore by ferric iron and sulfuric acid chemical attack. Biomining microorganisms allow the recycling of these products by oxidizing ferrous iron and/or sulfur compounds. The energy released from the oxidation of these substrates is used for the growth of the acidophilic chemolithoautotrophic bacterium Acidithiobacillus ferrooxidans. The respiratory pathways involved in these respiratory processes have been deciphered and the expression of the genes encoding these redox proteins is dependent on the electron donor present in the medium. Furthermore, in the presence of both ferrous iron and sulfur, the genes involved in iron oxidation are expressed before those involved in sulfur oxidation. We propose that the global redox responding two component system RegBA is responsible for this regulation since (i) the redox potential increases during iron oxidation but remains stable during sulfur oxidation and (ii) the transcriptional regulator RegA binds the regulatory region of a number of genes/operons involved in iron and sulfur oxidation. To understand the mechanism of the At. ferrooxidans RegBA system, the regA gene and the DNA corresponding to the DNA binding domain of RegA were cloned in an expression plasmid in Escherichia coli. The recombinant proteins, RegA and RegA-HTH respectively, were purified. The binding of RegA-HTH, phosphorylated and unphosphorylated RegA on the regulatory region of some target operons have been compared by gel shift mobility assay.

The antihypertensive effect of carteolol, a new potent nonselective beta‐adrenergic antagonist, was investigated in a double‐blind, parallel study of 35 patients with mild‐to‐moderate, essential hypertension whose blood pressures were not adequately controlled with a diuretic. Patients were randomly assigned to receive placebo, carteolol 5 mg, or carteolol 20 mg once a day in addition to hydrochlorothiazide 50 mg for six weeks. Thirty‐four patients completed the study: 11 patients received placebo (group 1), 12 patients received carteolol 5 mg (group 2), and 11 patients received carteolol 20 mg (group 3). After six weeks of treatment, the two groups that received carteolol had significant reductions in systolic (SBP) and diastolic (DBP) blood pressure from baseline in both the supine and standing positions. In group 2, mean SBP decreases for supine and standing positions were 11 ± 2.1 and 11 ± 1.9 mm Hg, respectively (P < .01) and 8 ± 1.2 and 9 ± 1.3 mm Hg, respectively, for DBP (P < .01); whereas in group 3, values were 8 ± 2.8 and 12 ± 3.0 mm Hg for SBP, in 5 ± 1.9 and 9 ± 3.1 mm Hg, respectively, for DBP (P < .01). The hypotensive effect was associated with slight but significant decreases in heart rate (P < .01 in group 2 andP < .05 in group 3). Reductions in SBP and DBP with the 20‐mg dose were not significantly different from those with the 5‐mg dose. With both carteolol regimens, the fall in mean blood pressure did not correlate with the initial level; but in the group taking the 5‐mg dose, it did correlate significantly with the decrease in heart rate (r = .72, P < .01). Side effects attributable to carteolol were infrequent and did not persist during continued therapy. It is concluded that carteolol, when combined with hydrochlorothiazide, is effective in reducing blood pressure in patients with mild to moderate hypertension.

The article relates the views of the author and midwife on female genital mutilation for childbirth. She works at a maternity health facility in Salford, England and assisted a woman who had undergone female genital mutilation, which has led her to discover more about female genital mutilation and how it affects women. Evidently, the procedure has a significant life-long negative health impact on women.

The article relates experiences and views of the author and midwife at a birth center during the labor and water birth by a patient named Lucy. Apparently, another midwife named Catherine did not allow Lucy to birth in the pool as she had not been trained in water births. The author expressed her concern over the fact that some birth center facilities would withheld some facilities to women during labor owing to lack of knowledge or experience on the midwife's part.