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As a component of an undergraduate nursing program evaluation, the purpose of this study was to investigate the effect of the psychiatric clinical learning site on students' attitudes toward mental illness and psychiatric nursing. A pretest-posttest quasi-experimental design was utilized. The dependent measures included an Environmental Rating Scale, an Attitude Toward Mental Illness Scale, and an Attitude Toward Psychiatric Nursing Scale. The non-probability sample of convenience included 45 students enrolled in the senior level psychiatric nursing module of a baccalaureate nursing program at a midwest, metropolitan liberal arts college. The subjects were randomly assigned to a Veterans Administration (VA) Medical Center and a private hospital. The results indicated that after controlling for students' attitudes toward mental illness and psychiatric nursing prior to the psychiatric nursing module, clinical site location did not account for any significant variance in students' attitudes after the module. However, correlation analysis of the specific components of the Environmental Rating Scale did demonstrate statistically significant associations with a decrease in authoritative, restrictive attitudes toward mental illness, and an increase in the milieu therapy and community mental health orientations to psychiatric nursing.

The Board of Directors of the National Council of State Boards of Nursing evaluates the NCLEX-RN examination passing standard every 3 years. In December 2006, the Board decided that the NCLEX-RN passing standard should be increased from -0.2800 to -0.2100 logits. This article provides information regarding standard-setting methodologies, empirical data used by the Board of Directors in determining the passing standard, and implications of the new passing standard for faculty.

BackgroundPatients with cancers that exhibit extraordinarily high somatic mutation numbers are ideal candidates for immunotherapy and enable identifying tumor-specific peptides through stimulation of tumor-reactive T cells (Tc).MethodsColorectal cancers (CRC) HROC113 and HROC285 were selected based on high TMB, microsatellite instability and HLA class I expression. Their HLA ligandome was characterized using mass spectrometry, compared with the HLA ligand atlas and HLA class I-binding affinity was predicted. Cryptic peptides were identified using Peptide-PRISM. Patients’ Tc were isolated from either peripheral blood (pTc) or tumor material (tumor-infiltrating Tc, TiTc) and expanded. In addition, B-lymphoblastoid cells (B-LCL) were generated and used as antigen-presenting cells. pTc and TiTc were stimulated twice for 7 days using peptide pool-loaded B-LCL. Subsequently, interferon gamma (IFNγ) release was quantified by ELISpot. Finally, cytotoxicity against autologous tumor cells was assessed in a degranulation assay.Results100 tumor-specific candidate peptides—97 cryptic peptides and 3 classically mutated neoantigens—were selected. The neoantigens originated from single nucleotide substitutions in the genesIQGAP1, CTNNB1,andTRIT1. Cryptic and neoantigenic peptides inducing IFNγ secretion of Tc were further investigated. Stimulation of pTc and TiTc with neoantigens and selected cryptic peptides resulted in increased release of cytotoxic granules in the presence of autologous tumor cells, substantiating their improved tumor cell recognition. Tetramer staining showed an enhanced number of pTc and TiTc specific for the IQGAP1 neoantigen. Subpopulation analysis prior to peptide stimulation revealed that pTc mainly consisted of memory Tc, whereas TiTc constituted primarily of effector and effector memory Tc. This allows to infer that TiTc reacting to neoantigens and cryptic peptides must be present within the tumor microenvironment.ConclusionThese results prove that the analyzed CRC present both mutated neoantigenic and cryptic peptides on their HLA class I molecules. Moreover, stimulation with these peptides significantly strengthened tumor cell recognition by Tc. Since the overall number of neoantigenic peptides identifiable by HLA ligandome analysis hitherto is small, our data emphasize the relevance of increasing the target scope for cancer vaccines by the cryptic peptide category.

When nurses who are educated internationally immigrate to the United States, they are expected to have English language proficiency in order to function as a competent nurse. The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL™). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures, the Simulated Minimally Competent Candidate (SMCC) procedure and the Examinee Paper Selection Method, were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220. Because the adoption of this standard rests entirely with the individual state, NCSBN has little more to do with implementing the standard, other than answering questions and providing documentation about the standard.