Purpose: The COVID-19 pandemic has increased the importance of nurses' clinical performance, and accordingly, nursing educators have emphasized students' clinical practice and performance. This study developed a Clinical Practice Self-Efficacy Scale for nursing students and examined its psychometric properties. Methods: The authors reviewed instruments for selecting items for the scale in the areas of clinical skills, communication, infection control, safety, and nursing process. After preliminary items were selected, ten experts consisting of nursing professors and clinical nurses reviewed the items considering Korean clinical and educational situations. The data for the psychometric evaluation was collected from 257 nursing students in their 2nd, 3rd, and 4th years and then analyzed. Results: The confirmatory factor analysis showed that the goodness of fit of this scale with five factors represented by 40 items was appropriate. The significant positive correlations with general self-efficacy indicated sound construct validity. The senior nursing students showed higher scores than others, as we expected. Cronbach’s alpha was .94. Conclusion The Clinical Practice Self-Efficacy Scale is appropriate for measuring Korean nursing students' self-efficacy of clinical practice. It is expected to act as a good tool to measure the effects of clinical practice education.

Purpose: This study aimed to develop an intentional rounding protocol to enhance the clinical competence of nursing students. Methods: An intentional rounding protocol for nursing students’ clinical practice was developed following the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A convenient sampling method was used to select 23 junior year university nursing students during their clinical practice in adult nursing. The program evaluation included a quantitative assessment (communication and relationship efficacy, empathy, and patient safety competency) and focus group interviews. Results: The intentional rounding protocol focused on the 4Ps (pain, position, potty, and possessions) and encompassed aspects such as level of consciousness, pain management, personal care needs, intravenous injection, oxygen administration, nasogastricasoenteric tube care, maintenance of urine collection bags, and the identification of environmental fall risks. Nursing students performed intentional rounding at least twice a day. Following the implementation of this protocol, nursing students demonstrated a significant improvement in communication and interpersonal efficacy. The focus group interviews revealed four main themes: growth of human relationships, acquiring knowledge in and about the clinical field, becoming a nurse, and barriers in reality. Conclusion The intentional rounding protocol has the potential to enhance nursing students’ communication and interpersonal skills during clinical practice and to provide them with positive experiences in nursing clinical education. Therefore, it is recommended that this protocol be incorporated into nursing clinical practice education.

Hematopoiesis involves a series of lineage differentiation programs initiated in hematopoietic stem cells (HSCs) found in bone marrow (BM). To ensure lifelong hematopoiesis, various molecular mechanisms are needed to maintain the HSC pool. CCCTC-binding factor (CTCF) is a DNA-binding, zinc-finger protein that regulates the expression of its target gene by organizing higher order chromatin structures. Currently, the role of CTCF in controlling HSC homeostasis is unknown. Using a tamoxifen-inducible CTCF conditional knockout mouse system, we aimed to determine whether CTCF regulates the homeostatic maintenance of HSCs. In adult mice, acute systemic CTCF ablation led to severe BM failure and the rapid shrinkage of multiple c-Kit(hi) progenitor populations, including Sca-1⁺ HSCs. Similarly, hematopoietic system-confined CTCF depletion caused an acute loss of HSCs and highly increased mortality. Mixed BM chimeras reconstituted with supporting BM demonstrated that CTCF deficiency-mediated HSC depletion has both cell-extrinsic and cell-intrinsic effects. Although c-Kit(hi) myeloid progenitor cell populations were severely reduced after ablating Ctcf, c-Kit(int) common lymphoid progenitors and their progenies were less affected by the lack of CTCF. Whole-transcriptome microarray and cell cycle analyses indicated that CTCF deficiency results in the enhanced expression of the cell cycle-promoting program, and that CTCF-depleted HSCs express higher levels of reactive oxygen species (ROS). Importantly, in vivo treatment with an antioxidant partially rescued c-Kit(hi) cell populations and their quiescence. Altogether, our results suggest that CTCF is indispensable for maintaining adult HSC pools, likely by regulating ROS-dependent HSC quiescence.
Adult ; Animals ; Bone Marrow ; Cell Cycle ; Chimera ; Chromatin ; Fibrinogen* ; Hematopoiesis ; Hematopoietic Stem Cells* ; Homeostasis ; Humans ; Lymphoid Progenitor Cells ; Mice* ; Mice, Knockout ; Mortality ; Myeloid Progenitor Cells ; Reactive Oxygen Species

Chemotherapeutic agents induce long-term side effects, including cognitive impairment and mood disorders, particularly in breast cancer survivors who have undergone chemotherapy. However, the precise mechanisms underpinning chemotherapy-induced hippocampal dysfunction remain unknown. In this study, we investigated the detrimental effects of chronic treatment with a combination of adriamycin and cyclophosphamide (AC) on the neuronal architecture and functions of the hippocampi of female C57BL/6 mice. After chronic AC administration, mice showed memory impairment (measured using a novel object recognition memory task) and depression-like behavior (measured using the tail suspension test and forced swim test). According to Golgi staining, chronic AC treatment significantly reduced the total dendritic length, ramification, and complexity as well as spine density and maturation in hippocampal neurons in a sub-region-specific manner. Additionally, the AC combination significantly reduced adult neurogenesis, the extent of the vascular network, and the levels of hippocampal angiogenesis-related factors. However, chronic AC treatment did not increase the levels of inflammation-related signals (microglial or astrocytic distribution, or the levels of pro-inflammatory cytokines or M1/M2 macrophage markers). Thus, chronic AC treatment changed the neuronal architecture of the adult hippocampus, possibly by reducing neurogenesis and the extent of the vasculature, independently of neuroinflammation. Such detrimental changes in micromorphometric parameters may explain the hippocampal dysfunction observed after cancer chemotherapy.
Adult ; Animals ; Breast Neoplasms ; Cognition Disorders ; Cyclophosphamide ; Cytokines ; Doxorubicin ; Drug Therapy ; Female ; Hindlimb Suspension ; Hippocampus ; Humans ; Macrophages ; Memory ; Mice* ; Mood Disorders ; Neurogenesis ; Neurons ; Spine ; Survivors