Neuregulin expression, function, and signaling in human ovarian cancer cells.

PURPOSE: To investigate the expression and function of neuregulin (NRG) isoforms in ovarian cancer cell lines and tumor samples. EXPERIMENTAL DESIGN: Expression of NRG-1alpha and NRG-1beta proteins were detected by immunohistochemistry and mRNA by RT-PCR. erbB receptor levels and downstream signaling proteins were measured by Western blot analysis. RESULTS: Expression of NRG-1alpha and NRG-1beta proteins were detected by immunohistochemistry in 46 of 53 (87%) and 41 of 53 (77%) ovarian carcinomas, respectively. Serous carcinomas express higher levels of NRG-1alpha than endometrioid carcinomas (P = 0.017). NRG mRNA was detected by RT-PCR in 20 of 24 (83%) of ovarian carcinomas and eight of nine (89%) ovarian cancer cell lines. NRG-1alpha stimulated the growth of 5 of 14 cell lines whereas NRG-1beta stimulated 7 of 14 cell lines. The magnitude of NRG growth response was significantly associated with erbB2 expression levels. NRG-1alpha and -1beta (1 nM) growth-stimulated cell lines PE01 and PE06 demonstrated increased tyrosine phosphorylation of erbB2 and elevated tyrosine phosphorylation of ERK1 and ERK2. In contrast, the SKOV-3 cell line, the growth of which was unaffected, did not show these downstream responses. An anti-erbB3 receptor antibody (clone H3.105.5) blocked NRG-1beta growth changes and signaling in these cell lines. Conversely, the anti-erbB4 antibody (clone H4.72.8) enhanced NRG-beta1 growth stimulation. Herceptin also inhibited growth. CONCLUSIONS: With NRG expression in the majority of ovarian carcinomas and cell lines, there is the potential for autocrine regulation of cell growth. Interfering with ligand-receptor interactions by receptor blocking antibodies suggests erbB3 is primarily involved in NRG-1beta-induced proliferation, with erbB4 having a more complex role.

Implementation of the ANA report card.

A major challenge in healthcare today is measuring the quality of care. To explore nursing's contribution to patients in acute care settings, the American Nurses Association commissioned the development of the "Nursing Report Card." This study explored whether these report card indicators capture quality care. The convenience sample comprised 1,500 patients and 300 nurses from 16 units at an academic medical center. Using regression analysis, the most consistent predictor of outcome indicators was the percentage of RNs of the total staff.

Do nurses know what patients think is important in nursing care?

In order for a nurse to provide quality care, she or he must know what patients expect from the nurse. Previous research into nurses' insight into patients' expectations of care have been based on idiosyncratic instruments or instruments that measure the perspective of the provider, not the patient. Using the 90 items from the Patient's Perception of Quality Scale-Acute Care Version, an instrument developed from qualitative interviews of patients, 448 patients and 350 nurses from the medical surgical units in seven hospitals ranked the items, patients from their perspective and nurses as they perceived patients would rank them. While the rank order of items was similar across patients and nurses, nurses consistently underestimated the extent to which patients valued most aspects of good nursing care.

Effects of case management on the nursing context--perceived quality of care, work satisfaction, and control over practice.

PURPOSE: To examine in 1995 the effects of case management on the context of nursing practice-perceived quality of care delivered, work satisfaction, and control over nursing practice-rather than the commonly studied effect on fiscal outcomes. DESIGN: Prospective quasi-experimental. Sampled were nurses on four units at one community hospital where patients with DRG 107 (Coronary Artery Bypass Graft, with no cardiac catheterization) were traditionally hospitalized. METHODS: Registered nurses on these units completed quality of care, satisfaction, and practice-control scales before and 1 year after implementation. FINDINGS: Significant positive differences were found in several aspects of perceived quality of care for both staff nurses and case managers, with specific increases found in nurses' perceived ability to develop relationships with patients, ability to be therapeutic, and support for good care from the institutional structure and administration. A significant decrease in nurses' satisfaction with their pay and other rewards as well as respect from colleagues was found. Case managers were found to have significantly increased perceptions of control over their practice. CONCLUSIONS: Case management was found to have a primarily positive effect on nurses-staff and case managers alike. There were significant increases in several aspects of the nurses' perceptions of the quality of care delivered. Additionally, case managers were more satisfied with the administration, the respect they received, and their pay and rewards in the institution. Most strikingly, case managers perceived themselves to have more control over their practice. Some negative effects of the program were a decrease in satisfaction with the pay and rewards by the staff who were not case managers.

Relationship between traditional quality indicators and perceptions of care.

A study was undertaken to examine the relationships between patient's perceptions of care received, nurses' perceptions of care delivered, and traditional measures of nursing care quality. Findings suggest that traditional quality indicators used in hospitals across the country have little in common with either patients' or nurses' perceptions of quality of care.

Research utilization by nurse managers: current practices and future directions.

Forty nurse managers from seven hospitals were surveyed about barriers to utilization of research. The highest rated barriers were related to the acquisition and understanding of research; the lowest rated barriers pertained to the need for research as a basis for nursing practice. Managers with diploma and associate degree preparation and those in rural hospitals perceived themselves as having more barriers in research skills and awareness of research than did baccalaureate and master's prepared managers and managers in urban hospitals. Implications for nurse executives include support for research active environments and the time and education necessary for involvement in research and research utilization activities.

Development and testing of the Nursing Role Model Competence Scale (NRMCS).

Although contact with appropriate role models is considered essential for adequate professional socialization, no instruments exist for the measurement of role modeling or role model competence in nursing. The aim of this study was to develop and test a measure of perceived role model competence. Initial item sources for the Nursing Role Model Competence Scale (NRMCS) were literature-based. Twenty nine items were compiled for content validity assessment by two panels of persons identified as clinical and educational role models. Eight additional items were added as a result of the expert review and mailed to 2,000 baccalaureate and higher degree nurses in a southwestern state. Of the 1,053 respondents, 951 provided complete data on the NRMCS. Psychometric evaluation of the NRMCS included item-total correlations (.42-.70), principal axis factor analysis with varimax rotation (51% of the variance accounted for), reliability estimation using alpha and theta estimates (> .77) and item-factor correlations (.41-.70). The four NRMCS factors--Positive Regard, Competence, Assertive Leader and Professional Advocate--were statistically compared, with five of the six comparisons resulting in significant differences. Respondents with higher professional scores were found to rate their role models as more competent on the NRMCS factors.

Changes in nursing administration research priorities. A sign of the times.

Although research is the critical element in the advancement of knowledge, for research to contribute knowledge to the practice of nursing it must be focused on subjects germane to the practice arena. When the focus of research in a discipline is not congruent with the needs of the discipline, knowledge development is compromised. By comparing the aforementioned retrospective research reviews to the research priority lists, we see that published research in nursing administration has not been tied closely to identified priorities. Healthcare reform provides nursing administration with a renewed opportunity to focus its research on priority areas. With the implementation of healthcare reforms, the practice arena for nursing and nursing administration will shift from the acute care setting to community and home-based settings, necessitating a shift in research to address these new delivery settings and the required care systems. The priorities generated from the national consensus group represent that shift, and may provide meaningful foci for future nursing administration research.

Team research: development of "we" in nursing research.

Team (tem) n. 1. a. Two or more draft animals harnessed to a vehicle or farm implement, b. A vehicle along with the animal or animals harnessed to it. 2. A group of animals exhibited or performing together. 3. A group of players on the same side in a game. 4. Any group organized to work together.