The views of non-medical prescribing students and medical mentors on interprofessional competency assessment: a qualitative exploration.

The United Kingdom (UK) is one of the least restrictive countries in terms of scope of prescribing practice for non-medical prescribers and is a rapidly expanding group of professionals. In the United Kingdom nurse prescribers are assessed in practice by Designated Medical Practitioners (DMP) (doctors) which is a unique approach. In light of proposals to permit nurses to assess each other the benefits and challenges associated with current approach to interprofessional assessment warranted further exploration. The aim was to explore interprofessional competency assessment with nurse non-medical prescribing students and their DMPs. A descriptive qualitative research design was undertaken using semi-structured interviews and focus groups. The study was completed in a Scottish University that provides non-medical prescribing education to nurses, midwives and allied health professionals. Students (n = 6) participated in two focus groups at the start and end of their supervised learning and assessment in practice. DMPs (n = 6) participated in semi structured telephone interviews on completion of supervision. Utilising Clark's theory of interprofessional education, a thematic analysis was conducted. Professional identity influenced interpretation of prescribing competence with regards assessment and scope of practice. Students and DMPs learned with, from and about each other, and provided a platform for two-way learning and mutual professional respect. The interprofessional learning experience developed relationships and provided ratification for the prescribing role post qualification. Further exploration with key stakeholders and service users is recommended, prior to any changes to the designated professional group assigned to assessing non-medical prescribing competence

Assessing and addressing unmet needs in people affected by brain tumours

Introduction Guidelines recommend that brain tumour patients have their unmet needs assessed by a Holistic Needs Assessment (HNA), followed by appropriate support and care to maximise self-management. The aim of this study was to determine the role of HNA amongst brain tumour patients and their families. Methods A sequential mixed methods approach with three distinct phases was used. The first phase undertook a systematic review of available tools for HNA in brain tumours to determine if there was a psychometrically valid tool. This was followed by qualitative interviews and focus groups that explored patients’ and carers’ experiences and perceptions of unmet needs as well as strategies and support to assess and address these. The next phase was a realist synthesis of the HNA programmes in brain tumour patients which explored how HNA programmes could work. The thesis was underpinned by realist methods which were used to draw each of the phases of the thesis together. Results It was determined that there was no psychometrically valid tool that could be recommended for HNA in this group. Furthermore, there are significant challenges in using a patient completed HNA due to cognitive difficulties. Patients with brain tumours have diverse needs, but also unique compared to most other cancers due to the neurocognitive impairments. These also impact the carers as neurocognitive changes can be distressing but also cause a higher carer burden, therefore carers need specific support in their role. While the HNA as a process is useful in addressing unmet needs and enabling more self-management; the existing programme for HNA in UK is not suitable. Conclusions This thesis supported that a modified HNA programme may be beneficial in meeting the needs of brain tumour patients. Due to neuro-cognitive impairments, an assessment of the patient’s ability to self-manage, combined with inclusion and support of carers in HNA programmes for brain tumour patients, is needed to maximise the potential for self-management. The assessment and management of distress as well as increased access to the neuro-oncology team is also recommended. This research has proposed an alternative, novel practice-based model integrating the findings of this research

Exploration of healthcare professionals’ perceptions of take home naloxone dispensing in acute care areas. [Protocol]

This research aims to get an insight into and an understanding of perceptions and experiences of healthcare professionals regarding take home naloxone dispensing. Search results will be exported to the reference manager Mendeley, and duplicates removed. By giving equal consideration to quantitative and qualitative methods, the Research Critique Framework (Caldwell, 2005) was found to most accurately fit the requirements of this review. The authors used this tool in conjunction with a simple, self-developed scoring system out of eighteen in order to categorise quality and appropriateness of each study. The initial questions are rather general and should be considered for all studies, with focus on design and methodology. The framework then splits into two pathways for either qualitative or quantitative routes. The authors devised a simple grading method whereby each question was assigned a 'yes', 'no' or 'not applicable'. These were then scored numerically with percentages calculated and finally further categorised as poor (90%)

In-line Raman spectroscopy for characterization of an industrial poultry raw material stream

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Encoder–decoder neural networks for predicting future FTIR spectra – application to enzymatic protein hydrolysis

In the process of converting food-processing by-products to value-addedingredients, fine grained control of the rawmaterials, enzymes and process conditionsensures the best possible yield and eco-nomic return. However, when raw mate-rial batches lack good characterization andcontain high batch variation, online or at-line monitoring of the enzymatic reac-tions would be beneficial. We investigate the potential of deep neural networks inpredicting the future state of enzymatic hydrolysis as described by Fourier-trans-form infrared spectra of the hydrolysates. Combined with predictions of averagemolecular weight, this provides a flexible and transparent tool for process moni-toring and control, enabling proactive adaption of process parameters.publishedVersio

A review of the impact of utilising electronic medical records for clinical research recruitment

Introduction:Recruitment is an important aspect of clinical research, as poor recruitment could undermine the scientific value of a trial or delay the development process of new treatments. The development of electronic medical records provides a new way to identify potential participants for trials by matching the eligibility criteria with patients’ data within electronic medical records.Methods:A literature search was performed to examine the effectiveness and efficiency of the electronic medical record recruitment method using MEDLINE, PubMed, PubMed Central, CINAHL Plus with Full Text, ScienceDirect and Cochrane Library databases. These searches generated 11 articles that met the eligibility criteria, and handsearching reference lists generated two additional articles bringing the total number of articles to 13. These articles were subjected to critical appraisal utilising the Effective Public Health Practice Project tool.Results:Out of the 13 included articles, 11 provided quantitative data on recruitment effectiveness while seven articles provided quantitative data on recruitment efficiency. The automation in screening and patient identification by using alerts, a notification system, to notify research staff of a potential participant, was observed to contribute to higher recruitment yield and reduced workload due to its specificity on participant screening. The use of electronic medical record alerts was found to be associated with better recruitment outcomes when they were sent to dedicated research staff rather than physicians. Using electronic medical records for recruitment was found to be effective due to its capability for patient identification outside working hours and fast processing time, which was particularly useful for clinical trials in acute conditions. Several challenges may hinder the impact of the electronic medical record recruitment method, including the lack of conformity of clinical trial eligibility criteria and electronic medical record data structure and missing data. ‘Alert fatigue’ could also impact on the effectiveness of this method in the long term.Conclusion:The results from this review supports electronic medical record being an effective and efficient method for clinical trial recruitment. Recommendations were made in order to maximise the potential of the electronic medical record recruitment method and also for future research in order to improve the quality of evidence to support this strategy for recruitment

Calanus finmarchicus as a novel source of health-promoting bioactive peptides: Enzymatic protein hydrolysis, characterization, and in vitro bioactivity

Calanus finmarchicus is a crustacean currently used as a source of marine lipid. The lipids are extracted by enzymatic protein hydrolysis, while the remaining peptide fraction is regarded as a byproduct. In the present work, ten different commercial proteases and endogenous C. finmarchicus proteases were used to produce a set of 63 protein hydrolysates. Protease concentration and hydrolysis time were varied. Hydrolysates were characterized using size-exclusion chromatography and 1H nuclear magnetic resonance spectroscopy. Addition of commercial proteases had unremarkable effect on the yield and molecular weight distribution. This was attributed to the strong impact of endogenous enzymes dominating the hydrolysis process. However, multivariate classification based on 1H NMR spectra revealed subtle variations in composition of hydrolysates produced using different enzymes. The hydrolysates were further evaluated for DPP-IV inhibition and antioxidant activity. The hydrolysates showed significantly higher bioactivity than the unhydrolyzed control. A representative hydrolysate (CaFi55) was fractionated using semipreparative size-exclusion chromatography. A fraction consisting of short peptides with an average chain length of five amino acids (F2), was identified as a major contributor to the DPP-IV inhibitory activity (IC50 = 0.70 ± 0.07 mg/mL)

The views of non-medical prescribing students and medical mentors on interprofessional competency assessment – A qualitative exploration

BackgroundThe United Kingdom (UK) is one of the least restrictive countries in terms of scope of prescribing practice for non-medical prescribers and is a rapidly expanding group of professionals. In the United Kingdom nurse prescribers are assessed in practice by Designated Medical Practitioners (DMP) (doctors) which is a unique approach. In light of proposals to permit nurses to assess each other the benefits and challenges associated with current approach to interprofessional assessment warranted further exploration.ObjectiveThe aim was to explore interprofessional competency assessment with nurse non-medical prescribing students and their DMPs.DesignA descriptive qualitative research design was undertaken using semi-structured interviews and focus groups.SettingThe study was completed in a Scottish University that provides non-medical prescribing education to nurses, midwives and allied health professionals.Participants and methodsStudents (n?=?6) participated in two focus groups at the start and end of their supervised learning and assessment in practice. DMPs (n?=?6) participated in semi structured telephone interviews on completion of supervision. Utilising Clark's theory of interprofessional education, a thematic analysis was conducted.FindingsProfessional identity influenced interpretation of prescribing competence with regards assessment and scope of practice. Students and DMPs learned with, from and about each other, and provided a platform for two-way learning and mutual professional respect. The interprofessional learning experience developed relationships and provided ratification for the prescribing role post qualification.ConclusionsFurther exploration with key stakeholders and service users is recommended, prior to any changes to the designated professional group assigned to assessing non-medical prescribing competence