Medicine and Health Sciences Commons^™

Selecting Optimal Combinations Of Transcription Factors To Promote Axon Regeneration: Why Mechanisms Matter, Ishwariya Venkatesh, Murray G. Blackmore

Biomedical Sciences Faculty Research and Publications

Recovery from injuries to the central nervous system, including spinal cord injury, is constrained in part by the intrinsically low ability of many CNS neurons to mount an effective regenerative growth response. To improve outcomes, it is essential to understand and ultimately reverse these neuron-intrinsic constraints. Genetic manipulation of key transcription factors (TFs), which act to orchestrate production of multiple regeneration-associated genes, has emerged as a promising strategy. It is likely that no single TF will be sufficient to fully restore neuron-intrinsic growth potential, and that multiple, functionally interacting factors will be needed. An extensive literature, mostly from non-neural cell …

Digital Holographic Microscopy Of Phase Separation In Multicomponent Lipid Membranes, Vahideh Farzam Rad, Ali-Reza Moradi, Ahmad Darudi, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Lateral in-homogeneities in lipid compositions cause microdomains formation and change in the physical properties of biological membranes. With the presence of cholesterol and mixed species of lipids, phospholipid membranes segregate into lateral domains of liquid-ordered and liquid-disordered phases. Coupling of two-dimensional intralayer phase separations and interlayer liquid-crystalline ordering in multicomponent membranes has been previously demonstrated. By the use of digital holographic microscopy (DHMicroscopy), we quantitatively analyzed the volumetric dynamical behavior of such membranes. The specimens are lipid mixtures composed of sphingomyelin, cholesterol, and unsaturated phospholipid, 1,2-dioleoyl-sn-glycero-3-phosphocholine. DHMicroscopy in a transmission mode is an effective tool for quantitative visualization of phase …

Impact Of Wisconsin Medicaid Policy Change On Dental Sealant Utilization, Christopher Okunseri, Elaye Okunseri, Raul I. Garcia, Cesar Gonzales, Alexis Vistocky, Aniko Szabo

School of Dentistry Faculty Research and Publications

Background

In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings.

Objective

This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change.

Data Source

The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009.

Study Design

Retrospective claims data analysis of Wisconsin Dental Medicaid for children aged 6-16 years.

Principal Findings

A total of 479,847 children followed up for 1,441,300 person-years with 64,546 visits were analyzed. The …

Differences In Utilization Of Dental Procedures By Children Enrolled In Wisconsin Medicaid And Delta Dental Insurance Plans, Pradeep Bhagavatula, Qun Xiang, Aniko Szabo, Fredrick Eichmiller, Christopher Okunseri

School of Dentistry Faculty Research and Publications

Background

Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0–18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008.

Methods

Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to …

Epigenetic Profiling Reveals A Developmental Decrease In Promoter Accessibility During Cortical Maturation In Vivo, Ishwariya Venkatesh, Matthew T. Simpson, Denise M. Coley, Murray G. Blackmore

Biomedical Sciences Faculty Research and Publications

Axon regeneration in adult central nervous system (CNS) is limited in part by a developmental decline in the ability of injured neurons to re-express needed regeneration associated genes (RAGs). Adult CNS neurons may lack appropriate pro-regenerative transcription factors, or may display chromatin structure that restricts transcriptional access to RAGs. Here we performed epigenetic profiling around the promoter regions of key RAGs, and found progressive restriction across a time course of cortical maturation. These data identify a potential intrinsic constraint to axon growth in adult CNS neurons. Neurite outgrowth from cultured postnatal cortical neurons, however, proved insensitive to treatments that improve …

Development Of Plga-Coated Β-Tcp Scaffolds Containing Vegf For Bone Tissue Engineering, Arash Khojasteh, Farahnaz Fahimipour, Mohamadreza Baghaban Eslaminejad, Mohammad Jafarian, Shahrbanoo Jahangir, Farshid Bastami, Mohammadreza Tahriri, Akbar Karkhaneh, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Bone tissue engineering is sought to apply strategies for bone defects healing without limitations and short-comings of using either bone autografts or allografts and xenografts. The aim of this study was to fabricate a thin layer poly(lactic-co-glycolic) acid (PLGA) coated beta-tricalcium phosphate (β-TCP) scaffold with sustained release of vascular endothelial growth factor (VEGF). PLGA coating increased compressive strength of the β-TCP scaffolds significantly. For in vitro evaluations, canine mesenchymal stem cells (cMSCs) and canine endothelial progenitor cells (cEPCs) were isolated and characterized. Cell proliferation and attachment were demonstrated and the rate of cells proliferation on the VEGF released scaffold was …

Efficacy Of The Biomaterials 3 Wt%-Nanostrontium-Hydroxyapatite-Enhanced Calcium Phosphate Cement (Nanosr-Cpc) And Nanosr-Cpc-Incorporated Simvastatin-Loaded Poly(Lactic-Co-Glycolic-Acid) Microspheres In Osteogenesis Improvement, Reza Masaeli, Tahereh S. Jafarzadeh Kashi, Rassoul Dinarvand, Vahid Rakhshan, Hossein Shahoon, Behzad Hooshmand, Fatemeh Mashhadi Abbas, Majid Raz, Alireza Rajabnejad, Hossein Eslami, Kimia Khoshroo, Mohammadreza Tahriri, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Aims

The purpose of this multi-phase explorative in vivo animal/surgical and in vitro multi-test experimental study was to (1) create a 3 wt%-nanostrontium hydroxyapatite-enhanced calcium phosphate cement (Sr-HA/CPC) for increasing bone formation and (2) creating a simvastatin-loaded poly(lactic-co-glycolic acid) (SIM-loaded PLGA) microspheres plus CPC composite (SIM-loaded PLGA + nanostrontium-CPC). The third goal was the extensive assessment of multiple in vitro and in vivo characteristics of the above experimental explorative products in vitro and in vivo (animal and surgical studies).

Methods and results pertaining to Sr-HA/CPC

Physical and chemical properties of the prepared Sr-HA/CPC were evaluated. MTT assay and …

Short Implants Had Lower Survival Rates In Posterior Jaws Compared To Standard Implants, Gary L. Stafford

School of Dentistry Faculty Research and Publications

Data sources

PubMed/Medline, Embase and Cochrane Library databases supplemented by searches of the journals; Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, International Journal of Oral and Maxillofacial Implants, International Journal of Oral and Maxillofacial Surgery, Journal of Clinical Periodontology, Journal of Dentistry, Journal of Oral and Maxillofacial Surgery, Journal of Oral Implantology, Journal of Oral Rehabilitation, Journal of Periodontology, Periodontology 2000.

Study selection

Randomised controlled trials (RCTs) and prospective studies with at least ten patients, published in the last ten years that compared short and standard implants and published in English were considered.

Data extraction and …

The Role Of Spirituality And Religiosity In Persons Living With Sickle Cell Disease, Dora L. Clayton-Jones, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose: Sickle cell disease (SCD) is a serious debilitating chronic illness, affecting approximately 90,000 Americans and millions globally. Spirituality and religiosity (S/R) may ease the burden faced by persons living with SCD. The purpose of this study was to examine the role of S/R in adolescents and adults living with SCD in the research literature.

Method: The electronic databases Cumulative Index to Nursing and Allied Health Literature, Health Source Nursing/Academic, ProQuest Health Module, PsycINFO, Medline, PubMed, and the American Theological Library Association were searched from January 1995 to December 2014.

Findings: Of the 89 studies retrieved, 11 articles between 2001 …

Recent Advancements In Regenerative Dentistry: A Review, Pouya Amrollahi, Brinda Shah, Amir Seifi, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Although human mouth benefits from remarkable mechanical properties, it is very susceptible to traumatic damages, exposure to microbial attacks, and congenital maladies. Since the human dentition plays a crucial role in mastication, phonation and esthetics, finding promising and more efficient strategies to reestablish its functionality in the event of disruption has been important. Dating back to antiquity, conventional dentistry has been offering evacuation, restoration, and replacement of the diseased dental tissue. However, due to the limited ability and short lifespan of traditional restorative solutions, scientists have taken advantage of current advancements in medicine to create better solutions for the oral …

Introducing Allergenic Food Into Infants' Diets: Systematic Review, Katelin Larson, Jessica Mclaughlin, Mallory Stonehouse, Brittany Young, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose: The purpose of this systematic review was to explore the association between timing of introduction of potentially allergenic foods to infants and development of food allergies.

Methods: CINAHL, Medline, PubMed, Science Direct, and Web of Science were searched using the terms solid food, complementary food, or infant feeding combined with allergy or hypersensitivity for articles published in English in 2000 or later. Inclusion criteria were 1) primary research articles with 2) a focus on association between introduction of complementary foods including potentially allergenic foods into diets of infants less than 12 months of age and development of food allergies. …

Lubricin In Synovial Fluid Of Mild And Severe Temporomandibular Joint Internal Derangements, Rosalia Leonardi, Rosario E. Perrotta, Luis Eduardo Almeida, Carla Loreto, Giuseppe Musumeci

School of Dentistry Faculty Research and Publications

Background: To understand the molecular basis of temporomandibular joint (TMJ) pathologies, we aimed to investigate the lubricin levels in the TMJ synovial fluid (SF) of patients with mild to severe internal derangements (IDs). Material and Methods: A total, 34 joints were the study group. Only patients, with a Wilkes stage of III, IV and V were included, in this sample. Control group consisted of SF from eight joints, from patients undergoing to orthognatic surgery. Concentrations of lubricin in the SF from both samples were measured using ELISA system. Results: The mean lubricin concentration was 7.029 ± 0.21 µg/mL in stage …

The Relevance Of Sex Differences In Performance Fatigability, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Performance fatigability differs between men and women for a range of fatiguing tasks. Women are usually less fatigable than men, and this is most widely described for isometric fatiguing contractions and some dynamic tasks. The sex difference in fatigability is specific to the task demands so that one mechanism is not universal, including any sex differences in skeletal muscle physiology, muscle perfusion, and voluntary activation. However, there are substantial knowledge gaps about the task dependency of the sex differences in fatigability, the involved mechanisms, and the relevance to clinical populations and with advanced age. The knowledge gaps are in part …

Patient/Family Education For Newly Diagnosed Pediatric Oncology Patients, Wendy Landier, Joann Ahern, Lamia P. Barakat, Smita Bhatia, Kristin M. Bingen, Patricia G. Bondurant, Susan L. Cohn, Sarah K. Dobrozsi, Maureen Haugen, Ruth Anne Herring, Mary C. Hooke, Melissa Martin, Kathryn Murphy, Amy R. Newman, Cheryl C. Rodgers, Kathleen S. Ruccione, Jeneane Sullivan, Marianne E. Weiss, Janice Withycombe, Lise Yasui, Marilyn Hockenberry

College of Nursing Faculty Research and Publications

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad …

Development And Psychometric Analysis Of The Patient Perceptions Of Patient-Empowering Nurse Behaviours Scale (Pppnbs), Teresa Jerofke-Owen, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Aim

To (1) develop and psychometrically test the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale, which measures patient perceptions of empowering nurse behaviours during hospitalization; and (2) refine to a shorter, more useful form, for measurement in clinical settings.

Background

Although patient empowerment has been promoted as a way to engage patients in chronic illness care, there is not a measure reported by patients as recipients of empowering nurse behaviours during hospitalization.

Design

Psychometric evaluation of construct and predictive validity, reliability and item reduction.

Method

Data gathered during hospitalization and six weeks postdischarge between April 2012 - August 2014 were …

Interprofessional Health Team Communication About Hospital Discharge: An Implementation Science Evaluation Study, Sarah J. Bahr, Danielle M. Siclovan, Kristi Opper, Joseph Beiler, Kathleen Bobay, Marianne E. Weiss

College of Nursing Faculty Research and Publications

The Consolidated Framework for Implementation Research guided formative evaluation of the implementation of a redesigned interprofessional team rounding process. The purpose of the redesigned process was to improve health team communication about hospital discharge. Themes emerging from interviews of patients, nurses, and providers revealed the inherent value and positive characteristics of the new process, but also workflow, team hierarchy, and process challenges to successful implementation. The evaluation identified actionable recommendations for modifying the implementation process.

Autism Spectrum Disorder And The Child's Weight–Related Behaviors: A Parents' Perspective, Michele Polfuss, Norah L. Johnson, Susan A. Bonis, Fallon Apollon, Kathleen Sawin

College of Nursing Faculty Research and Publications

Purpose

To explore parent perspectives of how the attributes of their child's autism spectrum disorder(ASD) impact nutrition, physical activity, screen time behaviors and risk for obesity. Secondarily, we examined the parent's perception of the healthcare providers (HCP) influence on these weight-related behaviors.

Design and method

We conducted and audio-recorded telephone interviews with parents of children with ASD (n = 8) using a structured question guide. Data were transcribed and thematic analysis was conducted. Issues surrounding weight-related behaviors and parental strategies used were reported.

Results

Two overarching themes with eight subthemes emerged: (1) Challenges related to features of ASD (subthemes included …

Resilience In Adolescents Who Survived A Suicide Attempt From The Perspective Of Registered Nurses In Inpatient Psychiatric Facilities, Denise M. Matel-Anderson, Abir K. Bekhet

College of Nursing Faculty Research and Publications

The number of deaths by suicide has increased over the last few years. The purpose of this qualitative study is to explore components of resilience in adolescents who survived a suicide attempt from the perspective of nine psychiatric nurses. Resilience was used as a guiding conceptual framework which proposes that resilience is the interplay between risk and protective factors. Three categories emerged including risk factors, protective factors, and future recommendations of suicide prevention strategies. The perspectives gained from this study will help develop nursing interventions for adolescents to overcome risk factors and to build on their protective factors.

Anti-Müllerian Hormone Levels And Urinary Cortisol In Women With Chronic Abdominal Pain, Theresa M. Hardy, Donna O. Mccarthy, Nicolaas Fourie, Wendy Henderson

College of Nursing Faculty Research and Publications

Abstract

Objective

To explore the association of hypothalamic–pituitary–adrenal activity with ovarian functioning in women with and without chronic abdominal pain (CAP).

Design and Setting

A secondary data analysis was performed with data from female participants in a natural history protocol at the National Institutes of Health.

Participants

A total of 36 women (age range = 19–39 years, mean = 27.11 years) were included in the study.

Methods

This pilot study was conducted with a subset of participants enrolled in a natural history protocol conducted in the Hatfield Clinical Research Center at the National Institutes of Health. The parent study included …

Effects Of Oral Contraceptives On The Prevalence Of Alveolar Osteitis After Mandibular Third Molar Surgery: A Retrospective Study, Luis Eduardo Almeida, Sean Pierce, K. Klar, K. Sherman

School of Dentistry Faculty Research and Publications

The objective of this study was to investigate the influence of oral contraceptives on the incidence rate of alveolar osteitis (AO) following the surgical extraction of both impacted mandibular third molars. This retrospective study reviewed the clinical records of patients who presented to the oral surgery clinic of a university school of dentistry for the extraction of impacted mandibular third molars. Using a database search, all patients were categorized by sex, age, occurrence of AO, and whether the females were taking oral contraceptives at the time of surgery. The patient was considered positive for AO if either one or both …

Parallel Reference Speaker Weighting For Kinematic-Independent Acoustic-To-Articulatory Inversion, An Ji, Michael T. Johnson, Jeffrey J. Berry

Speech Pathology and Audiology Faculty Research and Publications

Acoustic-to-articulatory inversion, the estimation of articulatory kinematics from an acoustic waveform, is a challenging but important problem. Accurate estimation of articulatory movements has the potential for significant impact on our understanding of speech production, on our capacity to assess and treat pathologies in a clinical setting, and on speech technologies such as computer aided pronunciation assessment and audio-video synthesis. However, because of the complex and speaker-specific relationship between articulation and acoustics, existing approaches for inversion do not generalize well across speakers. As acquiring speaker-specific kinematic data for training is not feasible in many practical applications, this remains an important and …

A Systematic Review Of The Relationship Between Familism And Mental Health Outcomes In Latino Population, Esmeralds Valdivieso-Mora, Casie L. Peet, Mauricio Garnier-Villarreal, Monica Salazar-Villanea, David K. Johnson

College of Nursing Faculty Research and Publications

Background: Familismo or familism is a cultural value frequently seen in Hispanic cultures, in which a higher emphasis is placed on the family unit in terms of respect, support, obligation, and reference. Familism has been implicated as a protective factor against mental health problems and may foster the growth and development of children. This study aims at measuring the size of the relationship between familism and mental health outcomes of depression, suicide, substance abuse, internalizing, and externalizing behaviors. Methods: Thirty-nine studies were systematically reviewed to assess the relationship between familism and mental health outcomes. Data from the studies were comprised …

Evaluation Of The Healing Progress Of Pressure Ulcers Treated With Cathodal High-Voltage Monophasic Pulsed Current: Results Of A Prospective, Double-Blind, Randomized Clinical Trial, Anna Polak, Luther C. Kloth, Edward Blaszczak, Jakub Taradaj, Agnieszka Nawrat-Szoltysik, Lidia Bialek, Malgorzata Paczula, Andrzej Franek, Cezary Kucio

Physical Therapy Faculty Research and Publications

OBJECTIVE: To investigate the effectiveness of high-voltage monophasic pulsed current (HVMPC) as an adjunct to a standard wound care for the treatment of Stage II and III pressure ulcers (PrUs).

DESIGN: Prospective, randomized, double-blind, controlled clinical study.

SETTING: Two nursing and care centers.

PATIENTS: Patients with PrUs that did not respond to previous treatment for at least 4 weeks were randomly assigned to the electrical stimulation (ES) group (25 patients; mean age of 79.92 ± 8.50 years; mean wound surface area [WSA] of 10.58 ± 10.57 cm²) or to the control group (24 patients; mean age of 76.33 …

Role Of Vascular Reactive Oxygen Species In Regulating Cytochrome P450-4a Enzyme Expression In Dahl Salt-Sensitive Rats, Kathleen M. Lukaszewicz, Mahesh P. Paudyal, John R. Falck, Julian H. Lombard

Physical Therapy Faculty Research and Publications

Objective

The potential contribution of CYP4A enzymes to endothelial dysfunction in Dahl salt-sensitive rats was determined by comparison to SS-5^BN consomic rats having chromosome 5 carrying CYP4A alleles from the BN rat introgressed into the SS genetic background.

Methods

The following experiments were performed in cerebral arteries from HS-fed SS and SS-5^BN rats ± the SOD inhibitor DETC and/or the superoxide scavenger Tempol: (i) endothelial function was determined via video microscopy ± acute addition of the CYP4A inhibitor DDMS or Tempol; (ii) vascular oxidative stress was assessed with DHE fluorescence ± acute addition of DDMS, l-NAME, or PEG-SOD; …

Edge Chipping Resistance And Flexural Strength Of Polymer Infiltrated Ceramic Network And Resin Nanoceramic Restorative Materials, Renos Argyrou, Geoffrey A. Thompson, Seok-Hwan Cho, David W. Berzins

School of Dentistry Faculty Research and Publications

Statement of problem

Two novel restorative materials, a polymer infiltrated ceramic network (PICN) and a resin nanoceramic (RNC), for computer-assisted design and computer-assisted manufacturing (CAD-CAM) applications have recently become commercially available. Little independent evidence regarding their mechanical properties exists to facilitate material selection.

Purpose

The purpose of this in vitro study was to measure the edge chipping resistance and flexural strength of the PICN and RNC materials and compare them with 2 commonly used feldspathic ceramic (FC) and leucite reinforced glass-ceramic (LRGC) CAD-CAM materials that share the same clinical indications.

Material and methods

PICN, RNC, FC, and LRGC material specimens …

Muscle-Specific Effective Mechanical Advantage And Joint Impulse In Weightlifting, Kristof Kipp, Chad Harris

Exercise Science Faculty Research and Publications

Lifting greater loads during weightlifting exercises may theoretically be achieved through increasing the magnitudes of net joint impulses or manipulating the joints’ effective mechanical advantage (EMA). The purpose of this study was to investigate muscle-specific EMA and joint impulse as well as impulse-momentum characteristics of the lifter-barbell system across a range of external loads during the execution of the clean. Collegiate-level weightlifters performed submaximal cleans at 65, 75, and 85% of their 1-repetition maximum (1-RM) while data from a motion analysis system and a force plate were used to calculate lifter-barbell system impulse and velocity, as well as net extensor …

Discussion: Advanced Technologies To Improve Wound Healing: Electrical Stimulation, Vibration Therapy, And Ultrasound-What Is The Evidence?, Luther C. Kloth

Physical Therapy Faculty Research and Publications

No abstract provided.

Mechanical Demands Of The Hang Power Clean And Jump Shrug: A Joint-Level Perspective, Kristof Kipp, Philip Malloy, Jordan Smith, Matthew D. Giordanelli, Michael T. Kiely, Christopher Geiser, Timothy J. Suchomel

Exercise Science Faculty Research and Publications

The purpose of this study was to investigate the joint- and load-dependent changes in the mechanical demands of the lower extremity joints during the hang power clean (HPC) and the jump shrug (JS). Fifteen male lacrosse players were recruited from an NCAA DI team, and completed three sets of the HPC and JS at 30%, 50%, and 70% of their HPC 1-Repetition Maximum (1-RM HPC) in a counterbalanced and randomized order. Motion analysis and force plate technology were used to calculate the positive work, propulsive phase duration, and peak concentric power at the hip, knee, and ankle joints. Separate three-way …

Lessons Learned: Newly Hired Nurses' Perspectives On Transition Into Practice, Carolyn Ziebert, Carol Klingbeil, Catherine A. Schmitt, Alice V. Stonek, Joan P. Totka, Ashley Stelter, Rachel Schiffman

College of Nursing Faculty Research and Publications

This descriptive qualitative study explored data from debriefs of all newly hired nurses at 3, 6, and 12 months posthire during a newly designed transition-to-practice program at a pediatric hospital. Four major themes emerged: preceptors, education process, adaptation to the organization, and role transition. Supportive factors included staged orientation, limited preceptors, mentors, regular communication with leaders, and a culture of teamwork. Stressors included too many preceptors, mentorship needs, floating, communication challenges, and organizational changes.

Nursing Student Perceptions Regarding Simulation Experience Sequencing, Aimee A. Woda, Theresa Gruenke Schnable, Penny Alt-Gehrman, Jamie Hansen

College of Nursing Faculty Research and Publications

BACKGROUND:

The use of simulated learning experiences (SLEs) have increased within nursing curricula with positive learning outcomes for nursing students. The purpose of this study is to explore nursing students' perceptions of their clinical decision making (CDM) related to the block sequencing of different patient care experiences, SLEs versus hospital-based learning experiences (HLEs).

METHOD:

A qualitative descriptive design used open-ended survey questions to generate information about the block sequencing of SLEs and its impact on nursing students' perceived CDM.

RESULTS:

Three themes emerged from the data: Preexperience Anxiety, Real-Time Decision Making, and Increased Patient Care Experiences.

CONCLUSION:

Nursing students identified …