Education pathways for graduate entry registered nurses to transition to advanced practice roles: A realist review

OBJECTIVE

Explore potential education and clinical pathways for nurses entering the profession through a Graduate Entry Nursing programme to transition to advanced practice roles.

DESIGN

Realist review.

REVIEW METHODS

A two stage process included 1) a systematic search of the following electronic databases EMCARE, MEDLINE, CINAHL, ERIC, and Scopus for published peer reviewed literature reporting academic pathways for graduates of graduate entry nursing programmes to progress to advanced nursing roles, and 2) consultation with key education programme stakeholders of graduate entry nursing programmes across Australasia, who undertook an inductive interpretive approach using realist logic to determine what works, for whom, and in what circumstances.

RESULTS

Twelve published articles that explored advanced practice academic pathways for graduate entry nursing graduates were synthesised in terms of context, mechanisms, and outcomes. Data were then interpreted as to what works, for whom, in what context, and why, to develop new understandings of opportunities for advanced practice pathways for these students. No specific tailored academic pathway for graduate entry nursing graduates to progress to advanced practice was identified. Important relationships were identified between financial imperatives, political drivers, and registration requirements.

CONCLUSIONS

Transformative strategies for new education pathways were identified as necessary to inspire innovation in nurturing graduate entry nurse graduates to progress to advanced practice roles. Effective collaboration and consultation within and across agencies and organisations are needed to both develop and implement accessible, expedient, and equitable programmes to enable this capable cohort to contribute to the health workforce.

Learning experiences of first year graduate entry nursing students in New Zealand and Australia: a qualitative case study

BACKGROUND

Graduate entry nursing programmes provide students with an accelerated pathway to becoming a registered nurse. Motivations for study, together with commonly shared characteristics of students enrolling in such programmes is becoming well documented, however, their experiences of studying for a professional qualification in this manner is less understood. As a means of maintaining the relevance of these fast-tracked programmes in the future, an understanding of graduate entry nursing students' experiences of academic teaching and clinical placements is imperative.

OBJECTIVE

To explore the academic and clinical experiences of students enrolled in the first year of graduate entry nursing programmes in New Zealand and Australia.

METHODS

A qualitative case study approach was taken. Here we report the experiences of nine students enrolled in their first year of a two-year graduate entry nursing programme during 2020. Semi-structured interviews were used for data collection and analysed using Braun and Clarke's thematic analysis.

FINDINGS

Three overarching themes were developed-affirmation, reflections on expectations and clinical experiences.

CONCLUSION

This study highlights the experiences of first year graduate entry nursing students, with many experiencing affirmation that their altruistic career visions came to fruition. The findings indicate that these graduate-entry nursing students interviewed for this study tended to be flexible and adaptable in their approach to study as a means of meeting the challenges of the programme, all of which are key characteristics for a registered nurse; with personal growth and the development of the self, providing preparation for their second year of study.

GEN: highly efficient SMILES explorer using autodidactic generative examination networks

Recurrent neural networks have been widely used to generate millions of de novo molecules in defined chemical spaces. Reported deep generative models are exclusively based on LSTM and/or GRU units and frequently trained using canonical SMILES. In this study, we introduce Generative Examination Networks (GEN) as a new approach to train deep generative networks for SMILES generation. In our GENs, we have used an architecture based on multiple concatenated bidirectional RNN units to enhance the validity of generated SMILES. GENs autonomously learn the target space in a few epochs and are stopped early using an independent online examination mechanism, measuring the quality of the generated set. Herein we have used online statistical quality control (SQC) on the percentage of valid molecular SMILES as examination measure to select the earliest available stable model weights. Very high levels of valid SMILES (95–98%) can be generated using multiple parallel encoding layers in combination with SMILES augmentation using unrestricted SMILES randomization. Our trained models combine an excellent novelty rate (85–90%) while generating SMILES with strong conservation of the property space (95–99%). In GENs, both the generative network and the examination mechanism are open to other architectures and quality criteria.

Genes alternations with exposure time of environmental factors

A theoretical model discussing the environmental factors (EFs) effect of exposure time on genes, which leads to human diseases, is presented using multi-logistic model. The advantages and limitations of this model are discussed in terms of its usefulness for simulating genetic samples. It has been shown that EFs affect genes with the same degree both at high exposure level, low exposure time and at low exposure level, high exposure time.

Urinary phytoestrogen levels related to idiopathic male infertility in Chinese men

Phytoestrogens (PEs) are naturally occurring chemical constituents of certain plants. The internal PE exposures, mainly from diet, vary among different populations and in different regions due to various eating habits. To investigate the potential relationship between urinary PE levels and idiopathic male infertility and semen quality in Chinese adult males, 608 idiopathic infertile men and 469 fertile controls were recruited by eligibility screening procedures. Individual exposure to PEs was measured using UPLC-MS/MS as spot urinary concentrations of 6 PEs (daidzein, DAI; equol, EQU; genistein, GEN; naringenin, NAR; coumestrol, COU; and secoisolariciresinol, SEC), which were adjusted with urinary creatinine (CR). Semen quality was assessed by sperm concentration, number per ejaculum and motility. We found that exposures to DAI, GEN and SEC were significantly associated with idiopathic male infertility (P-value for trend=0.036; 0.002; and 0.0001, respectively), while these exposures had stronger association with infertile subjects with at least one abnormal semen parameter than those with all normal semen parameters. Exposures to DAI, GEN and SEC were also related to idiopathic male infertility with abnormal sperm concentration, number per ejaculum and motility (P-value for trend<0.05), while these exposures had stronger association with the infertile men with abnormal sperm number per ejaculum. These findings provide the evidence that PE exposures are related to male reproductive function and raise a public health concern because that exposure to PEs is ubiquitous in China.

Genistein modulates oxidative stress in breast cancer cell lines according to ERα/ERβ ratio: effects on mitochondrial functionality, sirtuins, uncoupling protein 2 and antioxidant enzymes

Genistein is a biologically active isoflavone with estrogenic activity and can be found in a variety of soy products. This natural compound displays a wide array of biological activities, but it is best known for its ability to inhibit cancer progression, especially for hormone-related ones such as breast cancer. Genistein has been shown to bind both the estrogen receptor alpha (ERα) and the estrogen receptor beta (ERβ), although it has a higher affinity for the ERβ. The ERα/ERβ ratio is a prognostic marker for breast tumors, and ERβ expression could indicate the presence of tumors more benign in state, whereas ERα indicates malignant tumors. The objective of the present study was to investigate the effects of genistein on oxidative stress and mitochondrial functionality through its interaction with the estrogen receptor in breast cancer cell lines with different ERα/ERβ ratios. The lower ERα/ERβ ratio T47D cell line showed lower oxidative stress and greater mitochondrial functionality, along with an up-regulation of uncoupling protein 2 and sirtuins. On the other hand, genistein-treated MCF-7 cell line, with the highest ERα/ERβ ratio, reported no changes for the control situation. On the whole, our results show different genistein effects depending on ERα/ERβ ratio for oxidative stress regulation, mitochondrial functionality, and modulation of UCPs, antioxidant enzymes and sirtuins in breast cancer cell lines. Effects of genistein on oxidative stress and mitochondria could be due at least in part, to a higher ERβ presence, but could also be due to up-regulation of ERβ caused by the genistein treatment.