Barlowmalloy5679

OBJECTIVES To systematically evaluate, through a Medline search, the role of omalizumab in eosinophilic granulomatosis with polyangiitis (EGPA). METHODS A systematic review was performed with the following inclusion criteria original articles and case reports written in English and reporting an association between omalizumab and EGPA. RESULTS We found 18 papers on EGPA (14 case reports, 3 retrospective cohort studies, 1 prospective cohort study). Proteases inhibitor Omalizumab showed to be effective as corticosteroid-sparing agent in EGPA patients with severe asthmatic manifestations. On the contrary, conflicting results concerned its use in refractory forms of EGPA. Plausible is the increased risk of EGPA onset among asthmatic patients treated with omalizumab, probably related to steroid reduction, even if it cannot be excluded that omalizumab might be occasionally directly involved in the pathogenesis. CONCLUSIONS Our findings support the use of omalizumab in selected forms of EGPA, but caution in the tapering of corticosteroids is also recommended. Quality of evidence is limited, as the source of information was mainly case reports. Clinical trials are required in order to evaluate the role of omalizumab in EGPA and to ascertain the risk of asthmatic patients given omalizumab to develop EGPA.As we launch into the Year of the Nurse and Mid-wife, marking the 200th anniversary of Florence Nightingale's birth, there is much to look forward to in 2020. Numerous events and celebrations have been planned throughout the year, particularly with some schools of nursing also marking significant anniversaries. Indeed, in this country and others, there are many accomplishments to be celebrated in the context of the profession's evolution over the last two centuries. We should be proud but remain ever vigilant and appropriately responsive to circumstances that threaten our ability to sustain and effectively evolve into the future. Copyright © 2019 Longwoods Publishing.The Canadian Nursing Students' Association (CNSA) is the national voice of Canadian nursing students. Its goal is to increase the legal, ethical, professional and educational aspects of nursing, which are an integral part of the profession. The association is actively dedicated to the positive promotion of nurses and nursing as a whole. Since the implementation of the NCLEX-RN, CNSA has worked extensively to support nursing students as they write this entry-to-practice examination. On national and provincial platforms, CNSA has implored stakeholders to engage in an inclusive dialogue that results in increased support for nursing students with regard to the NCLEX-RN. Copyright © 2019 Longwoods Publishing.Since its creation in 1942, the Canadian Association of Schools of Nursing's mandate has been to foster high-quality nursing education in Canada in the interest of healthier Canadians. To this end, the Canadian Examination for Baccalaureate Nurses/l'examen canadien du baccalauréat en sciences infirmières (CEBN/ECBSI) has been developed and will be launched in 2020. Its purpose, what the Canadian Examination for Baccalaureate Nurses designation signifies and the development of the examination are described. Copyright © 2019 Longwoods Publishing.This article describes the experience of adopting the NCLEX-RN as an entry-to-practice exam among francophone baccalaureate nursing students in New Brunswick, Canada. The journey between 2012 and now has been difficult, and nursing leadership was necessary to inform key stakeholders regarding the inequities faced by francophone nursing students and to bring about change. Here is a description of the arduous work done by a group of concerned nurses (active and retired) to advocate for the rights of francophone nursing students. Copyright © 2019 Longwoods Publishing.In 2015, the traditional paper-and-pencil entry-to-practice exam in Canada was replaced by a computer-adaptive testing exam, the American National Council Licensure Examination for Registered Nurses (NCLEX-RN). As there are two official languages in Canada - English and French - the NCLEX-RN was translated to French. Although initially the pass rates for anglophone writers with the NCLEX-RN were lower than with the previous Canadian licensing exam, their pass rates have now increased. By contrast, francophone writers have continued to have lower pass rates, and a decreasing number of candidates are choosing to write the exam in French. A lack of access to French language preparatory resources is being reported by francophone graduates as one of the contributing factors. Canadian nursing regulators report that they are not responsible for ensuring that candidates have access to preparatory materials. However, given the bilingual culture and heritage in Canada, there is a responsibility to ensure equitable access to preparatory resources to ensure success on the licensing exam. This paper raises alarm about the decreasing number of francophone graduates writing the NCLEX-RN in French and the ongoing delivery of safe, quality nursing care to francophone patients by nurses proficient in the French language. Copyright © 2019 Longwoods Publishing.This commentary presents perspectives of two senior nursing professors who have extensive faculty and leadership experience in both Canada and the United States. To understand more about how the adoption of the National Council Licensure Examination-Registered Nurses (NCLEX-RN) examination in Canada came to be, the authors conducted conversations with 29 Canadian nurse educators and nursing education and practice leaders. Based on these conversations as well as a review of published materials on the topic, the authors conclude that regulatory leaders failed to involve key leaders and stakeholders from nursing education and practice in this decision, and the resulting negative consequences have been borne primarily by the education and practice sectors. The authors argue that the NCLEX-RN adoption has introduced a misalignment into what had been a well-aligned model of education, regulation and practice in Canada and invite readers to consider the following discussion points. First, the NCLEX-RN has been designed to operate within a healthcare system that should not, by any reasonable argument, be replicated elsewhere; therefore, what are the contextual factors that led to the Canadian adoption of the NCLEX-RN? Second, American regulators stipulate that the examination must fit associate degree graduate competencies and that the additional knowledge and competencies gained at the baccalaureate level are irrelevant for licensure purposes; however, is this a fit for Canadian nursing licensure that requires the baccalaureate degree as an entry for practice? In conclusion, as American higher education in nursing now begins to move toward a competency-based model, further changes will have to be implemented to shape and frame the future of nursing education in the United States, and by extension, the future development of the NCLEX-RN within Canada's distinct historical, social, political and institutional context.