Evaluating the Effectiveness of a Virtual Mock Interview for Health Professions Students.

BACKGROUND: Virtual mock interviews were offered to students to improve job interviewing skills. This educational quality improvement project aimed to use virtual mock interviews to increase student preparedness and confidence, and reduce anxiety related to professional interviews. METHOD: Health professions students (n = 19) participated in the mock interviews conducted and recorded through a web-based meeting. Students received the recorded interview to watch before follow-up. Students completed pre- and postquestionnaires that addressed students' preparedness, confidence, and anxiety related to interviewing. RESULTS: Participants' confidence and preparedness improved significantly in their virtual interviews (p < .001), and their anxiety decreased significantly after the virtual interviews (p < .001). After watching the interviews, students' reported eye contact needed improvement and answers included too many "uhms." CONCLUSION: Students benefited from the virtual mock interviews. Mock virtual job interviews may have a positive effect on successful job acquisition in health professions. [J Nurs Educ. 2023;62(8):479-482.].

Standardization of upper limb exercises to improve radiation therapy for breast cancer, a conceptual literature review.

INTRODUCTION: Many patients with breast cancer are left with upper arm mobility dysfunction following surgery. Despite the beneficial effects of upper limb exercises on shoulder dysfunction, radiation therapists still do not widely encourage patients to participate in arm exercises after surgery. This conceptual literature review synthesizes evidence on how patients with breast cancer that participate in upper limb exercises after surgery have improved arm mobility which could result in a more consistent arm position during radiation therapy. METHODS: A literature search was performed in the PubMed, Athabasca University Library, and Google Scholar databases to identify articles that evaluated the effect of upper limb exercises on patients' arm mobility and range of motion after breast cancer surgery, and the impact of arm position on anatomy during radiation therapy. Sixteen studies were included in the conceptual review synthesis. RESULTS: The studies were heterogeneous in terms of the utilized exercise methods and the upper limb related outcomes measured. Twelve studies demonstrated that upper arm exercises are an effective intervention in restoring arm mobility and decreasing pain in women with breast cancer. Additionally, four studies showed that differences in arm rotation affect the breast region's anatomy, which could result in set-up errors during radiation therapy. CONCLUSION: The effectiveness of radiation therapy for breast cancer treatment relies on women to reproduce their shoulder position each day. Any inability to replicate the arm position due to mobility issues can affect the accuracy of the dose delivered and, ultimately, the treatment outcome. Therefore, upper limb exercises should be recommended by radiation therapists to their patients before or during radiation therapy to improve patient comfort and the accuracy of treatment. Additionally, upper limb exercise standards need to be developed for patients with breast cancer and implemented by radiation therapists.

Evaluating Nursing Students' Perceptions of Using Quick Response Codes to Enhance Learning During Nursing Health Assessment.

ABSTRACT: Providing engaging activities to supplement classroom learning can be a challenge for today's nurse educator. Quick response (QR) code technology provides hands-on clinical experiences without the use of high-fidelity simulators. The purpose of this article is to evaluate how QR codes during a health assessment simulation activity enhanced learning for first-semester baccalaureate nursing students. The use of QR codes increased student confidence during health assessment with a form of technology they found engaging.

Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans Affairs (VA) MRSA bundle in a VA long-term care facility, 2004-2014.

A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation.

Depressive affect and hospitalization risk in incident hemodialysis patients.

BACKGROUND AND OBJECTIVES: Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether an association also exists with hospitalization risk. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All 8776 adult incident hemodialysis patients with Medical Outcomes Study Short Form 36 survey results treated in Fresenius Medical Care North America facilities in 2006 were followed for 1 year from the date of survey, and all hospitalization events lasting >24 hours were tracked. A depressive affect score was derived from responses to two Medical Outcomes Study Short Form 36 questions ("down in the dumps" and "downhearted and blue"). A high depressive affect score corresponded with an average response of "some of the time" or more frequent occurrence. Cox and Poisson models were constructed to determine associations of depressive affect scores with risk for time to first hospitalization and risk for hospitalization events, as well as total days spent in the hospital, respectively. RESULTS: Incident patients with high depressive affect score made up 41% of the cohort and had a median (interquartile range) hospitalization event rate of one (0, 3) and 4 (0, 15) total hospital days; the values for patients with low depressive affect scores were one (0, 2) event and 2 (0, 11) days, respectively. For high-scoring patients, the adjusted hazard ratio for first hospitalization was 1.12 (1.04, 1.20). When multiple hospital events were considered, the adjusted risk ratio was 1.13 (1.02, 1.25) and the corresponding risk ratio for total hospital days was 1.20 (1.07, 1.35). High depressive affect score was generally associated with lower physical and mental component scores, but these covariates were adjusted for in the models. CONCLUSIONS: Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days. Future studies are needed to investigate the effect of therapeutic interventions to address depressive affect in this high-risk population.

Neuropeptidase activity is down-regulated by estradiol in steroid-sensitive regions of the hypothalamus in female mice.

Thimet oligopeptidase (TOP) and prolyl endopeptidase (PEP) are neuropeptidases involved in the hydrolysis of gonadotropin-releasing hormone, a key component of the hypothalamic-pituitary-gonadal axis. GnRH is regulated in part by feedback from steroid hormones such as estradiol. Previously, we demonstrated that TOP levels are down-regulated by estradiol in reproductively-relevant regions of the female rodent brain. The present study supports these findings by showing that TOP enzyme activity, as well as protein levels, in the ventromedial hypothalamic nucleus of female mice is controlled by estradiol. We further demonstrate that PEP levels in this same brain region are down-regulated by estradiol in parallel with those of TOP. These findings provide evidence that these neuropeptidases are part of the fine control of hormone levels in the HPG axis.

Hydrogen bond residue positioning in the 599-611 loop of thimet oligopeptidase is required for substrate selection.

Thimet oligopeptidase (EC 3.4.24.15) is a zinc(II) endopeptidase implicated in the processing of numerous physiological peptides. Although its role in selecting and processing peptides is not fully understood, it is believed that flexible loop regions lining the substrate-binding site allow the enzyme to conform to substrates of varying structure. This study describes mutant forms of thimet oligopeptidase in which Gly or Tyr residues in the 599-611 loop region were replaced, individually and in combination, to elucidate the mechanism of substrate selection by this enzyme. Decreases in k(cat) observed on mutation of Tyr605 and Tyr612 demonstrate that these residues contribute to the efficient cleavage of most substrates. Modeling studies showing that a hinge-bend movement brings both Tyr612 and Tyr605 within hydrogen bond distance of the cleaved peptide bond supports this role. Thus, molecular modeling studies support a key role in transition state stabilization of this enzyme by Tyr605. Interestingly, kinetic parameters show that a bradykinin derivative is processed distinctly from the other substrates tested, suggesting that an alternative catalytic mechanism may be employed for this particular substrate. The data demonstrate that neither Tyr605 nor Tyr612 is necessary for the hydrolysis of this substrate. Relative to other substrates, the bradykinin derivative is also unaffected by Gly mutations in the loop. This distinction suggests that the role of Gly residues in the loop is to properly orientate these Tyr residues in order to accommodate varying substrate structures. This also opens up the possibility that certain substrates may be cleaved by an open form of the enzyme.

Calcifications are potential surrogates for prostate localization in image-guided radiotherapy.

PURPOSE: To investigate the feasibility of using calcifications as surrogates for the prostate position during cone-beam computed tomography (CBCT) image-guided radiotherapy. METHODS AND MATERIALS: The twice-weekly CBCT images taken during the treatment course of 4 patients were retrospectively studied for the stability of the calcifications. The geometric center of three fiducial markers was used as the reference. The planning CT images of 131 prostate patients recently treated with external beam radiotherapy at our center were reviewed to estimate the calcification occurrence rate. Analysis was conducted using the Varian Eclipse treatment planning system. Two patients were treated using prostate calcifications as the landmark in on-line registration. Both the Varian standard and the low-dose CBCT modes were used for imaging. RESULTS: The calcifications were found to be stable during the treatment course. At the 95% confidence interval, the difference between the distance from an identified calcification to the fiducial markers on CBCT and the distance on the planning CT scans was 0.2 +/- 2.0 mm, 0.8 +/- 2.2 mm, and 0.4 +/- 2.4 mm in the left-right, anteroposterior, and superoinferior direction, respectively. Of the 131 patients, 46 (35%) had well-defined calcifications either inside the prostate or near the borders. Our experience in treating the first 2 patients demonstrated that the calcifications are easily distinguished on low-dose scans and that calcification registration can be precisely performed. CONCLUSION: The results of our study have shown that calcifications can be reliable markers of prostate position and allow for precise image guidance with a low-imaging dose. With this approach, potentially about one-third of prostate patients could benefit from precise image guidance without the invasive use of markers.