Biomedical subjects

Michelle Reynolds

Publications and source records attributed to Michelle Reynolds.

3 recordsLinked to original sources

PubMed2005

Re-evaluating the NCLEX-RN passing standard.

Setting passing standards is a critical component of the NCLEX examination process. This research was conducted to provide sufficient information to the National Council of State Boards of Nursing's (NCSBN) Board of Directors to,make a decision regarding the passing standard of the NCLEX-RN. This article illustrates the standard setting process that NCSBN uses. Surveys of educators and employers, a modified Angoff procedure, the Beuk compromise, and global assessments by content experts were methods used. The Rasch model and a presumed ability distribution were used as the framework to integrate these diverse perspectives regarding minimal competence. The revised passing standard was -0.28 logits. For many of the minimal competence estimates, the author did not have authorization to release the information. In those instances, estimates and results were fabricated to be similar to the actual results, yet different enough as to not disclose confidential information. The fabricated results are clearly marked. In conclusion, a variety of approaches, sources, and perspectives are necessary for the establishment of fair and appropriate standards on the NCLEX-RN.

Clinical Competence↗

PubMed2004

Neoadjuvant and adjuvant chemotherapy with doxorubicin and docetaxel in locally advanced breast cancer.

Fifty patients with histologically confirmed stage III breast cancer were enrolled in this study of doxorubicin 50 mg/m2 and docetaxel 75 mg/m2 intravenously infused over 1 hour every 21 days with granulocyte colony-stimulating factor for 4 cycles. This was followed by surgery (mastectomy or lumpectomy) and 4 more cycles of doxorubicin/docetaxel postoperatively, then radiation and tamoxifen as indicated. Forty-six of the 50 patients (92%) completed neoadjuvant chemotherapy, and 38 patients (76%) completed adjuvant chemotherapy. Clinical response (defined as > 50% decrease in size of tumor) was achieved after 2 cycles in 37 patients (74%) and after 4 cycles in 42 of the 46 patients (91%) who finished neoadjuvant chemotherapy. Pathologic complete response (pCR; no pathologic invasive cancer) at the primary site was obtained in 7 of 46 patients (15%); 11 had no residual gross disease but did have microscopic persistence or microscopic complete response (mCR), for a combined pCR and mCR of 18 of 46 patients (39%). No treatment-related deaths occurred, but 3 patients died during treatment: 1 from progressive disease, 1 from a gastrointestinal bleeding, and 1 from unexplained sudden cardiac death. Dose-limiting toxicities were hematologic (grade 3 neutropenia in 5 patients and grade 4 in 23 patients). Congestive heart failure developed in 4 of 50 patients (8%), with a mean decrease in left ventricular ejection fraction (LVEF) of 20% in affected patients and 1 asymptomatic decrease in LVEF of 25%. At last follow-up, 10 patients had died of progressive disease, and 1 each from sudden cardiac death and lower gastrointestinal bleeding. In locally advanced breast cancer, neoadjuvant doxorubicin/docetaxel is a very active regimen that achieved pCR of 15% and a combined pCR and mCR of 39%, for an overall clinical response rate of 91%. Adjuvant chemotherapy was complicated by dropouts and congestive heart failure. This regimen should be used with close monitoring of cardiac function.

Adult↗

PubMed2003

Supporting persons with developmental disability--a new model.

The way we think about and care for people with developmental disability has changed. Twenty-five years ago, society believed that caregivers always knew what was best for their individual and that he or she must be shielded, even shut away from, the harms that could occur in society. Now, people with disability participate in all aspects of community life. They are educated in local schools, live at home or in their own home, and compete with others in the job market. Caregiving for people with developmental disability is no longer modeled on medicine or stigmatizing labels. Instead, caregivers have become support persons who focus on identifying community resources and making the environment friendlier and safer for persons with disability.

Adolescent↗