SUMMARY Accumulation of toxic metabolites in tyrosinemia type I (HT1) patients leads to chronic DNA damage and the highest risk for hepatocellular carcinomas (HCCs) of any human disease. Here we show that hepatocytes of HT1 mice exhibit a profound cell cycle arrest which, despite concomitant apoptosis resistance, causes mortality from impaired liver regeneration. However, additional loss of p21 in HT1 mice restores the proliferative capabilities of hepatocytes and renal proximal tubular cells. This growth response compensates cell loss due to uninhibited apoptosis and enables animal survival but rapidly leads to HCCs, renal cysts and renal carcinomas. Thus, p21’s antiproliferative function is indispensable for the suppression of carcinogenesis from chronically injured liver and renal epithelial cells and cannot be compensated by apoptosis.

Clinical preceptorship provides an essential aspect of nursing education for senior nursing students. This descriptive study identified perceptions of senior nursing students about their clinical preceptorship experiences, evaluated their perceived levels of competency and confidence in providing nursing care; and examined their perceived confidence level in relation to the perceived competency level of nursing skills. Researchers approached 134 culturally diverse senior nursing students enrolled in Preceptorship courses at one of the state-funded California universities and collected anonymous data from 95 students in academic years 2010-2012, using three instruments; Senior Preceptorship Experience Questionnaire, Graduate Nurse Survey, and Quality and Safety Education for Nurses tools. Results indicated that the clinical preceptorship improved students' perceived competency skills and confidence in providing nursing care. Outcomes demonstrated that the level of students' perceived competency was positively associated with the level of their interaction with preceptor. There was a significant correlation between the overall perceived competency level and confidence level of students; however there was no relationship between the amount of preceptor interaction and the degree of perceived confidence. This information is useful to nursing education as educators continue striving to reconcile the lack of preparedness for new staff roles that employers see in new graduates. International Journal of Nursing, Vol. 1(2), December 2014 Keywords IntroductionA senior preceptorship embraces culmination of students' roles as nursing students; and it helps students attain the very beginning of their nursing career as professional nurses. During this time, student nurses transition into functional independent nurses under the supervision of a preceptor that serves as a clinical expert, role model, and direct supervisor of the preceptee. The students, known as preceptees, are expected to increase their workload gradually, until they are able to take on the full patient assignment. Benefits from this experience may include building professional roles, competence, confidence, and socialization in the nursing practice; as well as developing and achieving personal goals, learning about accountability, and becoming more familiarized with the organizational culture. The sum of these skills allows preceptees to deliver quality care to their patients.Literature indicates that the transition from a student nurse to novice staff nurse could be a stressful experience. Student nurses felt frustrated when they did not receive adequate support during transition (Kumaran & Carney, 2014) and experienced significantly more stress during their academic preparation, especially during their senior clinical preceptorship than they did during the first year of employment (Younge, Myrick, & Haase, 2002). The change in role might increase unpleasant feelings such as frustration, anxiety, and depressed mood. These negative feelings (Mamchur &...

Objective: The transition to practice experience provides a useful process to integrate nursing knowledge, skills, and attitudes of newly graduated nurses before they assume the professional nurses' roles. The study examined the levels of perceived clinical competency, confidence, and professional role development skills of 114 culturally diverse novice nurses enrolled in 12-15 weeks of a collaborative RN residency program at a state funded California university during academic years 2009-2013. Methods: Descriptive pre-and post-program measures study assessed core competency and confidence of participants before and after the residency program using three instruments; a modified quality and safety education for nurses (QSEN) competency questionnaire, Preceptorship Experience Questionnaire, and Graduate Nurse Survey. Results: Compared to the pre-program sum, participants report to perceive the significantly higher levels of the post-program sum of competency skills in applying QSEN concepts and nursing process cycles that include assessment, planning, implementation, and evaluation as well as professional role development. Interestingly, participants report to feel it is very important to develop a trusting relationship with their preceptor and positive relationship with staff nurses. Participants also report to perceive the higher level of confidence in carrying out nursing care at the end of the program. Conclusions: Findings suggest that newly graduated nurses perceive the increased levels of clinical competency and confidence on their self-administered report after participating in the RN residency program.