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Biomedical subjects

Florence Myrick

Publications and source records attributed to Florence Myrick.

17 recordsLinked to original sources
PubMed2006

Conflict in the preceptorship or field experience: a rippling tide of silence.

A major component of the educative process in the professional disciplines is the field education/preceptorship experience in which students are afforded opportunities to develop professional competence under the tutelage of a practising professional and/or a university instructor. During this time students are exposed to competing discourses about what it means to think and act as nurses, teachers, doctors and social workers. Frequently, field teaching is characterized by conflictual situations involving students, field instructors and university faculty. Such conflict is poorly understood as indicated by the lack of literature available in the professional disciplines. The purpose of this study was to explore the phenomenon of conflict within the context of field teaching in professional education. Pivotal to this study was the issue of making sense of the conflict that prospective nurses, teachers, social workers and doctors experience in professional education within the practice realm and how such discourses shape their professional identities, practices and ultimate social values. At issue is the social construction of meaning that takes place within professional education. This study was conducted from the perspective of four professional programs including education, medicine, nursing and social work. The researchers focused on the final year of each program at a time when students were engaged in a major field/preceptorship experience in hospitals, schools, communities and social agencies. The experiences derived from the nursing data are presented in this paper.

Conflict, Psychological↗
PubMed2006

Research utilization and clinical nurse educators: A systematic review.

BACKGROUND: Clinical nurse educators and other linking agents such as clinical nurse specialists, advanced nurse practitioners, and nurses working in research leadership positions are an important link in the facilitation of evidence-based practice in health care organizations. AIM: The purpose of this paper is to report the findings of a systematic review of the literature regarding clinical nurse educators and research utilization, using the Promoting Action on Research Implementation in Health Services framework as a backdrop for the analysis. FINDINGS: There is a positive relationship between research utilization and attitude toward research, higher levels of education, and reading professional nursing journals among clinical nurse educators. The authors suggest that not all clinical nurse educators have the necessary critical appraisal skills and research knowledge to use research effectively in practice. CONCLUSIONS: Few studies have examined clinical nurse educators and the determinants of their research utilization behaviour in clinical practice. Future research on clinical nurse educators needs to focus on the outcomes of research utilization, including the effectiveness of their role as facilitators and the contexts in which they practice.

Clinical Nursing Research↗
PubMed2006

Grounded theory: an exploration of process and procedure.

Grounded theory, as an evolving qualitative research method, is a product of its history as well as of its epistemology. Within the literature, there have been a number of discussions focusing on the differences between Glaser's (1978, 1992) and Strauss's (1987, 1990) versions of grounded theory. The purpose of this article is to add a level of depth and breadth to this discussion through specifically exploring the Glaser-Strauss debate by comparing the data analysis processes and procedures advocated by Glaser and by Strauss. To accomplish this task, the authors present the article in two sections. First, they provide relevant background information on grounded theory as a research method. Second, they pursue a more in-depth discussion of the positions of Glaser, using Glaser's work, and Strauss, using Strauss's and Strauss and Corbin's (1990) work, regarding the different phases of data analysis, specifically addressing the coding procedures, verification, and the issue of forcing versus emergence.

Data Collection↗
PubMed2006

In vitro evaluation of the anti-HIV activity and metabolic interactions of tenofovir and emtricitabine.

BACKGROUND: Tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) are nucleoside reverse transcriptase inhibitors (NRTIs) with once-daily dosing approved for use in HIV-1 infection. We evaluated this combination for anti-HIV activity and intracellular metabolic interactions in vitro. METHODS: Intracellular anabolism of combinations of FTC and tenofovir (TFV) were studied in the human T leukaemic cell line CEM and human peripheral blood mononuclear cells (PBMCs). The anti-HIV activity of the combination was studied in the human T leukaemic MT-2 cell line against wild-type or mutant virus (K65R and M184V) and in PBMCs against wild-type virus. Antiviral synergy was quantitated by isobologram and MacSynergy methods. RESULTS: Both TFV and FTC were efficiently converted to their active metabolites in PBMCs and CEM cells. In CEM cells, there was a statistically significant increase in the levels of TFV diphosphate (P=0.047) and FTC triphosphate (P=0.0069) following a 24 h incubation with the combination compared with the levels seen with the individual drugs. In PBMCs, similar levels of active metabolites were observed for each drug when they were incubated iindividually or in combination. The combination of TFV and FTC displayed additive to synergistic activity against HIV replication in PBMCs and resulted in strongly synergistic anti-HIV activity in MT-2 cells against both wild-type and mutant virus. CONCLUSIONS: The combination of TFV and FTC showed additive to synergistic anti-HIV activity in vitro, which correlated with the levels of intracellular phosphorylation observed. These results support the use of these drugs as a dual NRTI backbone in combination therapy for the treatment of HIV-1.

Adenine↗
PubMed2005

Educating nurses for the knowledge economy.

When discussing the education of nurses for the knowledge economy it must be assumed that nursing is influenced by multiple factors reflective of the broader society in which it exists. These factors include civil society, social justice, and the public sector, all of which converge to shape nursing education and ultimately nursing practice. Over the past decade in particular, these factors have been greatly affected by what may be described as the hegemonic influences of the knowledge economy and the philosophical assumptions on which it is based, influences that are impacting directly on how the health system is evolving. The author posits, therefore, that it is incumbent on faculty to educate future nurses for the knowledge economy and to provide them with appropriate tools with which to meet the many challenges that confront them today and will invariably continue to confront them in the coming decades.

Commerce↗
PubMed2005

Effects of HIV Q151M-associated multi-drug resistance mutations on the activities of (-)-beta-D-1',3'-dioxolan guanine.

The multi-drug resistance HIV-1 genotype A62V/V75I/F77L/F116Y/Q151M is associated with resistance to many nucleoside reverse transcriptase inhibitors including AZT, ddI, ddC, d4T, abacavir, and 3TC. In this study, we evaluated the antiviral activity of (-)-beta-D-1',3'-dioxolan guanine (DXG) towards mutant HIV-1 containing V75I/F77L/F116Y/Q151M (V75Icomplex) and A62V/V75I/F77L/F116Y/Q151M (A62Vcomplex) in MT-2 cells. We further investigated the mechanism of resistance by studying the incorporation of DXG 5'-triphosphate (DXG-TP) during DNA synthesis by mutant enzymes containing single mutations at Q151M or A62V, and the V75Icomplex and A62Vcomplex using pre-steady state kinetic analysis. Our studies showed that mutant virus containing V75Icomplex and A62Vcomplex were both more than 23-fold resistant to DXG, and this correlated with the 68- and 20-fold resistance changes observed in the enzymatic assay. Compared to the wild-type enzyme, DXG-TP was incorporated 39- and 21-fold less efficiently by the mutant enzyme containing V75Icomplex and A62Vcomplex, mainly due to decreases in the rate of incorporation. The A62V mutation significantly increased the rate of incorporation (k(pol)) for both dGTP (3-fold) and DXG-TP (7.9-fold), while the binding affinity of A62V HIV-1 RT for DXG-TP was decreased 14-fold. At the enzyme level, the addition of the A62V mutation to V75I/F77L/F116Y/Q151M moderately (3.4-fold) reversed the resistance to DXG-TP.

Amino Acid Substitution↗
PubMed2005

Lack of a metabolic and antiviral drug interaction between tenofovir, abacavir and lamivudine.

OBJECTIVE: An anti-HIV regimen composed of the nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) tenofovir (TFV) disoproxil fumarate (TDF), abacavir (ABC) and lamivudine (3TC) has performed poorly in patients. This study evaluated the combination of TFV, ABC and 3TC for metabolic or antiviral antagonism in vitro. DESIGN: Procedures were developed to evaluate the in vitro metabolism and antiviral activity of drug combinations of TFV, ABC and 3TC in cell types relevant for HIV infection. METHODS: Anabolism of combinations of TFV and ABC were studied over a 24 h period in the human T leukaemic CEM lymphoblast cell line and human primary peripheral blood mononuclear cells (PBMCs) stimulated with human interleukin-2 and phytohaemagglutinin. The anti-HIV activity of combinations of TFV and ABC in the presence or absence of 3TC was studied in stimulated PBMCs infected with the HXB2 strain of HIV-1. RESULTS: Levels of the active metabolites produced from TFV and ABC after incubation with CEM or PBMCs showed no significant change upon introduction of the other NRTI. Moreover, the pool sizes for the natural substrates of 2'-deoxyadenosine triphosphate and 2'-deoxyguanosine triphosphate were also unchanged. In anti-HIV assays in PBMCs, the combination of TFV and ABC was found to be additive with respect to inhibition of HIV replication. Addition of 3TC to the combination did not result in synergistic or antagonistic effects. CONCLUSIONS: The poor efficacy of the triple NRTI regimen of TDF, ABC and 3TC is probably not due to a metabolic drug interaction resulting in antagonism of antiviral activity.

Adenine↗
PubMed2004

Enhancing critical thinking in the preceptorship experience in nursing education.

BACKGROUND: To date no research has been conducted to examine the process used in the preceptorship experience to enhance critical thinking at the graduate level. This study provides data that could revitalize the preceptor/learner relationship and in turn influence future preceptorship programmes in graduate nursing education. AIM: The purpose of this study was to examine the preceptorship experience and its role in the enhancement of critical thinking in graduate nursing education. DESIGN: A grounded theory approach was employed, through semi-structured, tape-recorded interviews. Overall, 45 interviews were completed with graduate nursing students ranging in age from 26 to 53 years, and master's and doctorally prepared preceptors who ranged in age from 47 to 58 years. In addition, a journal of personal reflections was kept by each of the researchers. Analysis of data included the process of open coding, theoretical coding, selective coding, reduction and comparison. FINDINGS: Data revealed that a process, designated The Relational Process, occurred in the preceptorship experience to enhance the critical thinking ability of graduate nursing students. This process was found to be a complex, ongoing interpersonal dynamic between the graduate student and assigned preceptor. CONCLUSIONS: The relational process that emerged from this study indicates that specific preceptor behaviours are pivotal to the enhancement of critical thinking of graduate nursing students and ultimately impact on the success or failure of the preceptorship experience.

Adult↗
PubMed2004

Pedagogical integrity in the knowledge economy.

Abstract In pedagogy, as in life generally, there are moral complexities and ambiguities intrinsic to the teaching-learning process. Within the context of the knowledge economy and globalization those complexities and ambiguities are proliferating. How we as educators address the interface between these complexities is critical to how well we and those we serve fare in the educational and practice environment. With the emergent corporate university culture it would seem that the major goal is to become a 'knowledge factory' or a site of knowledge creation. Increasingly its scientific and technological agenda is to focus on generating knowledge that would further the means and ends of economic growth and public policy. Traditionally, however, education has meant much more than this. Indeed, the original purpose of university education was designed to foster a desire for right conduct and good things which ultimately cannot be neatly packaged and delivered. Within this view, university educators would thus be expected to cultivate a climate of self-reflection in which learning can be fulfilling in itself. This paper explores the notion of globalization and its hegemonic influence on the university agenda and addresses how corporatism, a key dimension of globalization, is in effect usurping the very essence of the teaching-learning process.

Ethics, Professional↗
PubMed2004

In vitro combination of amdoxovir and the inosine monophosphate dehydrogenase inhibitors mycophenolic acid and ribavirin demonstrates potent activity against wild-type and drug-resistant variants of human immunodeficiency virus type 1.

Amdoxovir [(-)-beta-d-2,6-diaminopurine dioxolane (DAPD)] is a nucleoside analogue reverse transcriptase inhibitor of human immunodeficiency virus type 1 (HIV-1) replication. DAPD is deaminated by adenosine deaminase to the guanosine analogue dioxolane guanosine (DXG), which is subsequently phosphorylated to the corresponding 5' triphosphate (DXG-TP). DXG-TP competes with the natural substrate dGTP for binding to the enzyme-nucleic acid complex. Mycophenolic acid (MPA) and ribavirin (RBV), inhibitors of inosine monophosphate dehydrogenase (IMPDH), inhibit the de novo synthesis of guanine nucleotides, including dGTP. Reducing the intracellular levels of dGTP would be expected to augment the antiviral activity of analogues of deoxyguanosine. In this study we examined the effect of MPA and RBV on the anti-HIV activity of DAPD and DXG. When tested against wild-type virus, both MPA and RBV decreased the 50% effective concentration (EC(50)) for DXG by at least 10-fold. In contrast, both MPA and RBV increase the EC(50) value for zidovudine. MPA and RBV completely reversed the resistance to DXG observed with HIV isolates containing mutations which confer partial resistance to DAPD and DXG. Similarly, when tested against a mutant virus fully resistant to inhibition by DAPD (K65R/Q151M), MPA and RBV reduced the EC(50) for DAPD to within twofold of that for the wild type. The combination of MPA or RBV with DAPD or DXG did not result in increased cytotoxicity or reduced levels of mitochondrial DNA when tested at physiologically relevant concentrations. These studies suggest a potential role for the use of IMPDH inhibitors in combination therapy with amdoxovir in the treatment of HIV.

Antibiotics, Antineoplastic↗
PubMed2003

Preceptorship and interpersonal conflict: a multidisciplinary study.

BACKGROUND: The impetus for the study was the concern of teachers about the potentially deleterious effects of conflict in the preceptee-preceptor relationship. Preceptorship, in which students work alongside designated professionals in clinical settings, can provide opportunities to integrate theoretical and practice knowledge, and can play a part in professional development. However, students may experience communications and interpersonal problems with their preceptors and, if the conflict thereby generated is not challenged and resolved, negative outcomes can occur for students, preceptors and teachers. AIM: The purpose of the study was to explore the nature of conflict in preceptorship experiences. METHODS: A modified, simultaneous quantitative/qualitative triangulated method was used, with the quantitative results reported in this paper. A total of 548 questionnaires were mailed to students and preceptors in the final clinical experience of undergraduate programmes in four disciplines. The return rate was 42.7% (234 questionnaires). FINDINGS: Data revealed the prevalence of conflict, the degree to which this affected preceptorship relationships, factors occurring in the practicum that may contribute to conflict, the degree to which the conflict was resolved, and the outcomes of conflict. CONCLUSIONS: It is only through an understanding of the dynamics involved in conflict, and its negative effects on students, that teachers, preceptors and students alike can respond proactively to conflicts and become adept at seeking and implementing effective solutions.

Adult↗
PubMed2002

Preceptorship and critical thinking in nursing education.

Although preceptorship is being used increasingly by nursing faculty in the practice setting, little is known about how preceptors teach and even less is known about how critical thinking is being fostered in that relationship. The purpose of this study was to examine the process used in preceptorship to develop and promote the critical thinking ability of baccalaureate nursing students. Using the grounded theory method, this study was conducted in a large tertiary care hospital. Participants included fourth-year baccalaureate nursing students (preceptees) and their staff nurse preceptors. Data collection was composed of semistructured interviews and observations of the preceptors and preceptees as they worked together in the practice setting. Secondary data sources included documents considered appropriate to the study (e.g., nurse notes, student journals). By constant comparative analysis of the data, the findings of this study revealed a process that reflects the enabling of students by preceptors to develop and promote their critical thinking ability in the practice setting.

Adult↗
PubMedDate not supplied

Preceptor questioning and student critical thinking.

Questioning is fundamental to student learning. Not only does it enable students to elevate their level of thinking, but in the process it also affords them the opportunity to deal with their world intelligently. The practice setting is an environment rich in opportunity for enabling critical thinking through the use of questioning. In the preceptorship experience, preceptors are in a prime position to use questioning behaviors that can challenge the way preceptees think, encourage them to justify or clarify their assertions, promote the generation of original ideas, explanations, or solutions to patient problems, provide mental and emotional tools to help resolve dilemmas, promote discussion, and evaluate learning. This article discusses the importance of preceptor questioning for the development and promotion of student critical thinking. Contextually, the authors draw on the findings of a recent study in which preceptor questioning of the knowledge base, decision making, and actions of the preceptee were found to directly bring about or trigger their critical thinking. This article allows for some further reflection on that process and its contribution to the enhancement of the preceptorship experience.

Education, Nursing↗
PubMedDate not supplied

Student nurse stress in the preceptorship experience.

Student nurses appear to experience significantly more stress during their academic preparation than they do during the first year of employment. Preceptorship is among the most stressful of student experiences. It is within the context of a challenging and at times daunting work environment that two complete strangers (preceptor and student) strive to accommodate one another within a professional capacity. If the relationship between preceptor and student is less than successful, not only can it be frustrating and disheartening, but it can result in student stress and disillusionment about nursing and an inability to integrate and learn. Using a hypothetical case, the authors discuss the importance of student assessment, close communication between faculty and preceptors, and quick responses to student stress as a means by which to circumvent the serious potential of student burnout in the practice setting.

Burnout, Professional↗
PubMedDate not supplied

Preceptor behaviors integral to the promotion of student critical thinking.

In the practice setting, preceptors not only contribute to the relational aspect of the preceptorship experience but, through their behaviors, they also effectively promote the critical thinking ability of students. Through the use of a grounded theory method in a recent study, four specific preceptor-generated behaviors were identified as integral to the promotion of the critical thinking ability of basic baccalaureate nursing students in the practice setting: role modeling, facilitation, guidance, and prioritization. In this article, the description and meaning of these four behaviors are explored and their significance to preceptors and nurse educators who wish to ensure that the critical thinking ability of nursing students is fostered in the practice setting is discussed.

Clinical Competence↗
PubMedDate not supplied

Preceptorship and the preparatory process for undergraduate nursing students and their preceptors.

The purpose of this article was to research nursing students' and their assigned preceptors' views of preparation in relationship to a 340-hour preceptorship course. Using an author-generated mailed survey, 75 of 191 preceptors and 52 of the 187 students returned questionnaires. The findings revealed just under half of the students and preceptors did not believe that they were well prepared. Twenty-six percent of the preceptors believed they should receive a formal training program. The implications for this research are threefold: students and preceptors have concerns with preparation; a formal preceptorship course for students and preceptors may be warranted; and the evaluation component of the preceptorship experience in particular requires formal preparation, an unexpected finding derived from the open comments of the preceptors themselves.

Analysis of Variance↗