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An exam wrapper is a structured debriefing questionnaire designed to help students understand examination performance and develop improvement strategies. This mixed-methods pilot study sought to examine its impact on students' metacognitive skills in a fundamentals nursing class and to assess student perceptions of its usefulness. Metacognition was assessed using the Metacognitive Inventory for Nursing Students. Quantitative data were analyzed using the nonparametric Friedman test. Qualitative data were taken from four focus groups. Students who used the exam wrapper throughout the semester demonstrated significant improvement in metacognition over time (p = .014). Focus group data revealed that students did not find the exam wrapper to be helpful. The analysis revealed three themes: Reliance on Faculty, Overlap With Established Self-Regulated Learning Strategies, and Difficulty in Answering Exam Wrapper Questions. Although students may not perceive this tool as useful, those who repeatedly used it over time had increased metacognition. [J Nurs Educ. 2019;58(7):417-421.].

Previous studies have shown that nurses have negative attitudes toward caring for patients with substance use disorder (SUD); these negative attitudes also have been noted with nursing students. This study examined nursing students' attitudes toward and empathy for patients with SUD to determine whether there were differences across practice settings. Fifty-three students were surveyed before and after a 120-hour mentor-ship practicum; 25 students participated in focus groups. Students' empathy scores improved significantly across all practice settings, and students' attitudes improved significantly in all settings except maternal child health. Qualitative analysis revealed themes related to perceived lack of educational preparation, observing generational differences in nursing care, transitioning from fear to empathy, familial exposure, and feelings of helplessness and blame. Findings support the need for educational interventions in both academic and professional practice settings. [J Nurs Educ. 2020;59(3):149-153.].

As an assistant professor of nursing and nurse in an emergency department, I offer my perspective on being a patient with cancer and the element of feeling vulnerable associated with an “insiders” viewpoint of the health-care system.

Introduction Substance use disorder (SUD) is a persistent and long‐standing public health issue in the United States. While SUD is medically considered a chronic illness, it is also one that is viewed as self‐inflicted, thereby resulting in judgmental attitudes and stigmatization from care providers, specifically from nurses. Design In 2020, the authors completed an analytical cross‐sectional study that included open‐ended questions to examine nurses' knowledge and attitudes toward caring for patients with SUD across practice settings. Methods A conceptual model was constructed by examining original study data and published literature on SUD, re‐analyzing themes, determining constructs and variables, then coming to a consensus on critical aspects of the model. Conclusion The resulting conceptual model highlights antecedents of nursing behaviors that directly affect patient care outcomes, providing a roadmap to improving patient outcomes. Clinical relevance Understanding antecedents that affect nurses' attitudes and perceptions of patients with SUD highlights changes that can influence patient outcomes.

Biological reaction calorimetry, also known as biocalorimetry, has led to extensive applications in monitoring and control of different bioprocesses. A simple real-time estimator for biomass and growth rate was formulated, based on in-line measured metabolic heat flow values. The performance of the estimator was tested in a unique bench-scale calorimeter (BioRC1), improved to a sensitivity range of 8 mW l^sup -1^ in order to facilitate the monitoring of even weakly exothermic biochemical reactions. A proportional-integral feedback control strategy based on these estimators was designed and implemented to control the growth rate of Candida utilis, Kluyveromyces marxianus and Pichia pastoris by regulating an exponential substrate feed. Maintaining a particular specific growth rate throughout a culture is essential for reproducible product quality in industrial bioprocesses and therefore a key sequence for the step from quality by analysis to quality by design. The potential of biocalorimetry as a reliable biomass monitoring tool and as a key part of a robust control strategy for aerobic fed-batch cultures of Crabtree-negative yeast cells in defined growth medium was investigated. Presenting controller errors of less than 4% in the best cases, the approach paves the way for the development of a generally applicable process analytical technology platform for monitoring and control of microbial fed-batch cultures. [PUBLICATION ABSTRACT]

Introduction Healthcare professionals, particularly nurses, have negative attitudes towards individuals with opioid use disorder (OUD) and these attitudes can contribute to suboptimal care. The aim of this study was to identify stigma, barriers and facilitators experienced by members of the OUD community when interacting with the healthcare system. Design A qualitative exploratory design used semi‐structured focus group interviews to address the study aim. Methods Following IRB approval, purposive sampling was used to recruit participants with a history of OUD, family caregivers of individuals with OUD, and support group leaders from regional recovery groups to provide a broad perspective of stigmatizing issues and barriers to care. Focus group discussions were conducted, and video recorded using web‐based conferencing software. Transcripts from the focus groups and field notes were analyzed and coded into themes. Results Both structural and social determinants of health were identified by participants as stigmatizing and/or barriers to care. Thematic content analysis resulted in eight themes: stigmatizing language, being labeled, inequitable care, OUD as a chronic illness, insurance barriers, stigma associated with medications for OUD (MOUD), community resources, and nursing knowledge and care. Conclusion Members of the OUD community are challenged by both internal and external stigma when seeking healthcare. Stigma negatively affects public support for allocation of resources to treat OUD. Interventions aimed at reducing stigma are critical to support effective OUD treatment and prevent barriers to OUD care. Clinical Relevance Understanding the complex relationships between stigma and structural determinants of health will allow nursing science to develop educational interventions that provide the next generation of nurses with the knowledge, skills, and attitudes needed to advance health equity for individuals with OUD.

Understanding the growth characteristics of microorganisms is an essential step in bioprocessing, not only because product formation may be growth-associated but also because they might influence cell physiology and thereby product quality. The specific growth rate, a key variable of many bioprocesses, cannot be measured directly and relies on the estimation through other measurable variables such as biomass, substrate, or product concentrations. Techniques for real-time estimation of the specific growth rate in microbial fed-batch cultures are discussed in the present paper. The advantages and limitations of different models and various monitoring techniques are discussed, highlighting the importance of the specific growth rate in the development of fast, reliable, and robust processes for the production of high-value products such as recombinant proteins.[PUBLICATION ABSTRACT]

The study purpose was to describe students' perceptions of feedback after participating in a teaching strategy designed to foster a view of feedback as an opportunity for improvement. Although delivering and receiving constructive feedback are essential to the role of the professional nurse, feedback has been identified as a trigger for incivility in academia and practice. Twelve nurse educators from the Quality and Safety Education for Nurses Academic Task Force, located at nine schools of nursing across the nation, implemented a presentation about giving and receiving constructive feedback in junior and senior courses. Five hundred twenty-three students submitted a total of 985 posts or essays in response to viewing the presentation; seven themes were identified. Viewing this teaching strategy enabled nursing students to develop an awareness of the opportunity that constructive feedback presents for professional development, self-improvement, teamwork and collaboration, and patient safety.

Nursing students experience a great discrepancy between their ideal views of nursing obtained while in school and the realities of practice (Chappy, Jambunathan, & Marnocha, 2010). A key issue is role discrepancy which has been shown to result in difficult transitions into nursing and reality shock for the newly licensed nurse (Duchscher, 2009; Hickey, 2010; Young, Steunkel, & Bawel-Brinkley, 2008). Using the Reflection, Feedback, and Restructuring model as a conceptual framework, this study sought to examine if a shadow the nurse experience (STN) for novice baccalaureate nursing students led to a transformation in professional nursing role perceptions and goal development. Twelve sophomore level nursing students enrolled in a baccalaureate nursing program shadowed a registered nurse for a total of 16 hours and responded to guided reflective questions before and after the experience. Reflections were analyzed and synthesized through an interpretative phenomenological lens resulting in three themes related to role development before and three themes related to role development after the shadowing experience. Overall respondent's perspectives changed from a focus of the nurse as a primary caregiver in a hierarchal structure to a broader perspective recognizing the complexity of nursing and what it means to care. Additionally students linked practice to classroom learning and developed academic goals to address anticipated learning needs.

Reliable control of the specific growth rate (μ) in fed-batch fermentations depends on the availability of accurate online estimations of the controlled variable. Due to difficulties in measuring biomass, μ is typically estimated using reference models relating measurements of substrate consumption or oxygen uptake rate to biomass growth. However, as culture conditions vary, these models are adapted dynamically, resulting in complex algorithms that lack the necessary robustness for industrial applicability. A simpler approach is presented where biomass is monitored using dielectric spectroscopy. The measurements are subjected to online balances and reconciled in real time against metabolite concentrations and off-gas composition. The reconciled biomass values serve to estimate the growth rate and a simple control scheme is implemented to maintain the desired value of μ. The methodology is developed with the yeast Kluyveromyces marxianus, tested for disturbance rejection and validated with two other strains. It is applicable to other cellular systems with minor modifications.