The Report of the Evaluation of Fitness For Practice Pre-Registration Nursing and Midwifery Curricula Project

1.1 Introduction The debate about the competence of newly qualified nurses and midwives has a long and contentious history. Much of this debate has not been informed by a strong evidence-base, but has often relied on anecdote, personal experience and deeply held opinion. Recently, Clark and Holmes (2007) reported findings that in England ward mangers have low expectations of newly qualified nurses, who themselves reported feeling poorly prepared for their new role. Whether this reflects an accurate picture of real competence is open to question and this potential disjuncture between judgements about competency and actual competency is at the heart of this evaluation. The wider political debate on pre-registration curricula shows little sign of disappearing with the current RCN General Secretary questioning the competence of newly qualified nurses (Snow & Harrison 2008). Such pronouncements by high-profile figures have characterised much of the debate around preregistration education since the Project 2000 curriculum. The literature outlined in this chapter will extend to exploring social cognitive theory (Bandura 1977). Many evaluations of pre-registration curricula are atheoretical and it is the intention of this evaluation to avoid such a significant limitation by explicitly locating the evaluation within a theoretical framework

The \u27New Normal\u27 of Flooding in Portsmouth, Virginia: Perspectives, Experiences, and Adaptive Responses of Residents and Business Owners in Low to Moderate-Income Communities

[First three paragraphs from the Summary] This project is a part of a broader initiative - the Resilience Adaptation Feasibility Tool (RAFT) - that addresses the daunting challenges coastal communities are facing related to sea level rise and climate change (more information about RAFT is available here: https://ien.virginia.edu/raft). This aim of this project was to investigate how residents and business owners in low-to-moderate income communities in Portsmouth, Virginia cope with flooding, and to assess implications for how the local government can better engage with residents to better meet their information needs so they can be more resilient to flooding. The report uses two sources of data to assess our current knowledge of the experiences of these residents and business owners and their approaches to flood resilience: (1) the 2015 Adaption Response to Recurrent Flooding study1 conducted for the City of Portsmouth by Old Dominion University researchers, and interviews conducted in summer 2018 by the current research team. Combined, the findings from the 2015 survey and 2018 interviews suggest that although individual residents and business owners have more severe perceptions of flooding, very few actually invest in private mitigation efforts like purchasing flood insurance. Vulnerable residents in the low-to-moderate income Portsmouth neighborhoods that are the focus of this project are living in a “new normal.” This “new normal” is a way of life in which residents have learned to adapt to frequent flood events by utilizing their social networks despite facing significant financial constraints. However, this new normal may be in conflict with residents’ efforts to prepare and mitigate the future projections of rising regional sea level rise and nuisance flooding events

Developing an Institutional Arrangement for a Whole-of-Government and Whole-of-Community Approach to Regional Adaptation to Sea Level Rise: The Hampton Roads Pilot Project

Adaptation to sea level rise (SLR) requires coordination among local, state, and federal entities and collaboration across governments, nonprofits, businesses, and residents. This coordination and collaboration are reflected in institutional arrangements associated with a whole-of-government and whole-of-community approach to regional adaptation. This study analyzes the development of an interlocal agreement (ILA), the Hampton Roads Sea Level Rise Preparedness and Resilience Intergovernmental Planning Pilot Project (the Pilot Project), as an example of such an arrangement. This study assesses how factors throughout three phases of ILA development (initiation, implementation, and execution) influence outcomes and effectiveness. Drawing upon participant observation, document analysis, survey of participants, and interviews with key informants this study identifies factors that facilitate effective regional adaptation to SLR (impetus, agreement) and factors that hamper adaptation efforts (funding, ease of delivery), and offers insight into the complexities of institutional collective action to address contentious and challenging issues such as SLR

Nursing and Midwifery in Scotland: Being Fit for Practice

1.1 Introduction The debate about the competence of newly qualified nurses and midwives has a long and contentious history. Much of this debate has not been informed by a strong evidence-base, but has often relied on anecdote, personal experience and deeply held opinion. Recently, Clark and Holmes (2007) reported findings that in England ward mangers have low expectations of newly qualified nurses, who themselves reported feeling poorly prepared for their new role. Whether this reflects an accurate picture of real competence is open to question and this potential disjuncture between judgements about competency and actual competency is at the heart of this evaluation. The wider political debate on pre-registration curricula shows little sign of disappearing with the current RCN General Secretary questioning the competence of newly qualified nurses (Snow & Harrison 2008). Such pronouncements by high-profile figures have characterised much of the debate around preregistration education since the Project 2000 curriculum. The literature outlined in this chapter will extend to exploring social cognitive theory (Bandura 1977). Many evaluations of pre-registration curricula are atheoretical and it is the intention of this evaluation to avoid such a significant limitation by explicitly locating the evaluation within a theoretical framework

Characterizing a World Within the Hot-Neptune Desert: Transit Observations of LTT 9779 b with the Hubble Space Telescope/WFC3

We present an atmospheric analysis of LTT 9779 b, a rare planet situated in the hot-Neptune desert, that has been observed with Hubble Space Telescope (HST)/WFC3 with G102 and G141. The combined transmission spectrum, which covers 0.8–1.6 μm, shows a gradual increase in transit depth with wavelength. Our preferred atmospheric model shows evidence for H2O, CO2, and FeH with a significance of 3.1σ, 2.4σ, and 2.1σ, respectively. In an attempt to constrain the rate of atmospheric escape for this planet, we search for the 1.083 μm helium line in the G102 data but find no evidence of excess absorption that would indicate an escaping atmosphere using this tracer. We refine the orbital ephemerides of LTT 9779 b using our HST data and observations from TESS, searching for evidence of orbital decay or apsidal precession, which are not found. The phase-curve observation of LTT 9779 b with JWST NIRISS should provide deeper insights into the atmosphere of this planet and the expected atmospheric escape might be detected with further observations concentrated on other tracers such as Lyα

Characterising a World Within the Hot Neptune Desert: Transit Observations of LTT 9779 b with HST WFC3

We present an atmospheric analysis of LTT 9779 b, a rare planet situated in the hot Neptune desert, that has been observed with HST WFC3 G102 and G141. The combined transmission spectrum, which covers 0.8 - 1.6 $\mu$m, shows a gradual increase in transit depth with wavelength. Our preferred atmospheric model shows evidence for H$_{\rm 2}$O, CO$_{\rm 2}$ and FeH with a significance of 3.1 $\sigma$, 2.4 $\sigma$ and 2.1 $\sigma$, respectively. In an attempt to constrain the rate of atmospheric escape for this planet, we search for the 1.083 $\mu$m Helium line in the G102 data but find no evidence of excess absorption that would indicate an escaping atmosphere using this tracer. We refine the orbital ephemerides of LTT 9779 b using our HST data and observations from TESS, searching for evidence of orbital decay or apsidal precession, which is not found. The phase-curve observation of LTT 9779 b with JWST NIRISS should provide deeper insights into the atmosphere of this planet and the expected atmospheric escape might be detected with further observations concentrated on other tracers such as Lyman $\alpha$.Comment: Accepted for publication in A

NOD2, RIP2 and IRF5 Play a Critical Role in the Type I Interferon Response to Mycobacterium tuberculosis

While the recognition of microbial infection often occurs at the cell surface via Toll-like receptors, the cytosol of the cell is also under surveillance for microbial products that breach the cell membrane. An important outcome of cytosolic recognition is the induction of IFNα and IFNβ, which are critical mediators of immunity against both bacteria and viruses. Like many intracellular pathogens, a significant fraction of the transcriptional response to Mycobacterium tuberculosis infection depends on these type I interferons, but the recognition pathways responsible remain elusive. In this work, we demonstrate that intraphagosomal M. tuberculosis stimulates the cytosolic Nod2 pathway that responds to bacterial peptidoglycan, and this event requires membrane damage that is actively inflicted by the bacterium. Unexpectedly, this recognition triggers the expression of type I interferons in a Tbk1- and Irf5-dependent manner. This response is only partially impaired by the loss of Irf3 and therefore, differs fundamentally from those stimulated by bacterial DNA, which depend entirely on this transcription factor. This difference appears to result from the unusual peptidoglycan produced by mycobacteria, which we show is a uniquely potent agonist of the Nod2/Rip2/Irf5 pathway. Thus, the Nod2 system is specialized to recognize bacteria that actively perturb host membranes and is remarkably sensitive to mycobacteria, perhaps reflecting the strong evolutionary pressure exerted by these pathogens on the mammalian immune system

Duox, Flotillin-2, and Src42A Are Required to Activate or Delimit the Spread of the Transcriptional Response to Epidermal Wounds in Drosophila

The epidermis is the largest organ of the body for most animals, and the first line of defense against invading pathogens. A breach in the epidermal cell layer triggers a variety of localized responses that in favorable circumstances result in the repair of the wound. Many cellular and genetic responses must be limited to epidermal cells that are close to wounds, but how this is regulated is still poorly understood. The order and hierarchy of epidermal wound signaling factors are also still obscure. The Drosophila embryonic epidermis provides an excellent system to study genes that regulate wound healing processes. We have developed a variety of fluorescent reporters that provide a visible readout of wound-dependent transcriptional activation near epidermal wound sites. A large screen for mutants that alter the activity of these wound reporters has identified seven new genes required to activate or delimit wound-induced transcriptional responses to a narrow zone of cells surrounding wound sites. Among the genes required to delimit the spread of wound responses are Drosophila Flotillin-2 and Src42A, both of which are transcriptionally activated around wound sites. Flotillin-2 and constitutively active Src42A are also sufficient, when overexpressed at high levels, to inhibit wound-induced transcription in epidermal cells. One gene required to activate epidermal wound reporters encodes Dual oxidase, an enzyme that produces hydrogen peroxide. We also find that four biochemical treatments (a serine protease, a Src kinase inhibitor, methyl-ß-cyclodextrin, and hydrogen peroxide) are sufficient to globally activate epidermal wound response genes in Drosophila embryos. We explore the epistatic relationships among the factors that induce or delimit the spread of epidermal wound signals. Our results define new genetic functions that interact to instruct only a limited number of cells around puncture wounds to mount a transcriptional response, mediating local repair and regeneration