Experiences of early career nurses working in specialist adolescent/young adult cancer units: A narrative inquiry

This thesis applied a narrative inquiry methodology to explore the experiences of the early career nurse (ECN) working in adolescent/young adult cancer (AYAC) specialist settings in the United Kingdom. Nine nurses came forward and their stories were elicited over Zoom technology during the COVID-19 pandemic. Individual and whole cohort data were analysed using Clandinin and Connelly’s three-dimensional framework of temporality, sociality and space. Meanings were developed and synthesised that drew on wider theoretical perspectives such as emotional labour, intergenerationality and competence development theory. The findings revealed the work of these nurses as multi-faceted, involving a complex range of effort and labour. Significantly, this study highlighted the emotional labour enacted by the ECNs as a consequence of working with AYAC (aged 15-25yrs) and their parents, whose cancer treatment extends over prolonged periods of time. The ECNs, some of whom are of similar age to patients, contend with managing physical, organisational and cognitive demands in the highly pressurised NHS where nursing shortages are at an all-time high. The need to develop competence and strategies to manage the emotional burden of this work has been revealed along with tensions and risks, not only for ECNs, but also for managers and funders. The study places emphasis on recognising and learning how to nurse AYAC and attend to their developmentally appropriate healthcare needs

The description of Gyrodactylus corleonis sp. n. and G. neretum sp. n. (Platyhelminthes: Monogenea) with comments on other gyrodactylids parasitizing pipefish (Pisces: Syngnathidae)

The current work describes two new species of Gyrodactylus von Nordmann, 1832 collected from pipefish Syngnathus scovelli (Evermann et Kendall) and Syngnathus typhle L. during two separate gyrodactylosis episodes on fish held in a public aquarium located in northern Italy. The gyrodactylids collected from the skin, fins and gills of pipefish were subjected to a morphological analysis of the attachment hooks and the morphometric data were compared to the four species of Gyrodactylus previously described from syngnathid hosts, namely G. eyipayipi Vaughan, Christison, Hansen et Shinn, 2010, G. pisculentus Williams, Kritsky, Dunnigan, Lash et Klein, 2008, G. shorti Holliman, 1963 and G. syngnathi Appleby, 1996. Principal components analysis (PCA) of the morphological data indicated six clusters; two discrete groups among the specimens taken from the pipefish held in the Italian aquarium and four further groups representing G. eyipayipi, G. pisculentus, G. shorti and G. syngnathi. Molecular sequences of the ribosomal internal transcribed spacers (ITS1 and ITS2) and the 5.8S gene for the new species considered here were then compared with those available for other species in GenBank. The comparison did not reveal any identical match, supporting the morphological analysis that Gyrodactylus corleonis sp. n. from S. typhle and Gyrodactylus neretum sp. n. from S. scovelli represent distinct species. Both G. corleonis and G. neretum possess robust hamuli, marginal hook blades that curve smoothly from their sickle base to a point beyond the toe and, ventral bars with a broad median portion and a reduced membrane. Gyrodactylus corleonis, however, can be distinguished on the basis of its heart-shaped ventral bar; G. neretum has a 1:2 hamulus point:shaft ratio and a rectangular-shaped ventral bar. A redescription of the haptoral hard parts of the four species previously recorded on pipefish is also presented

Gyrodactylus orecchiae sp. n. (Monogenea: Gyrodactylidae) from farmed populations of gilthead seabream (Sparus aurata) in the Adriatic Sea

Gyrodactylus orecchiae sp. n. (Monogenea, Gyrodactylidae) is described from the skin, fins, eyes and gills of juvenile Sparus aurata L. (gilthead seabream) following two outbreaks of gyrodactylosis amongst stocks held in inshore floating cages on the Adriatic coast of Albania and Croatia. Fish were heavily infected (1000+ gyrodactylids/fish) with G. orecchiae which reportedly resulted in ~2–10% mortality amongst the infected stock. Morphologically, the haptoral hooks of G. orecchiae most closely resemble those of Gyrodactylus arcuatus Bychowsky, 1933 in the approximate shape of the ventral bar with its pronounced ventral bar processes and marginal hook sickles which possess a square line to the inner edge of the sickle blade and large rounded heels. The marginal hooks are also morphologically similar to those of Gyrodactylus quadratidigitus Longshaw, Pursglove et Shinn, 2003 and Gyrodactylus colemanensis Mizelle et Kritsky, 1967, but G. orecchiae can be readily discriminated from all three species by the characteristic infolding of the hamuli roots and the shape of the marginal hook sickle. Molecular sequencing of the ITS1, 5.8S, ITS2 regions (513+157+404 bp, respectively) of G. orecchiae and alignment with other gyrodactylids for which these same genomic regions have been determined, suggests that this is a new species. No similarities were found when the ITS1 region of G. orecchiae was compared with 84 species of Gyrodactylus available on GenBank

Experiences of early-career nurses working in specialist adolescent/young adult cancer units: A narrative inquiry

Aim To explore the experiences of early-career registered nurses working in specialist adolescent/young adult cancer units. Design Narrative Inquiry. Methods A purposive sample of nine early-career registered nurses from six specialist adolescent/young adult cancer units in the United Kingdom participated in online in-depth narrative conversations between October 2020 and January 2021. Data were analysed thematically using Clandinin and Connelly's (2000) metaphorical three-dimensional narrative inquiry approach focussed on commonplaces of temporality, sociality and place. Results The intensity and complexity of the nursing work associated with young patients and their families, over protracted periods, impacted the nurses personally and professionally. The similarity of age between patients and nurses was shown as having benefits as well as posing risks. The complexity of four types of nursing labour was highlighted: emotional, cognitive, physical and organizational providing justification for the provision of specialist training and support. Conclusion This study presents unique insights into the complex work of early-career nurses in specialist units that reveal challenges in caring for the distinct needs of this cancer patient population

Fire and grazing determined grasslands of central Madagascar represent ancient assemblages

The ecology of Madagascar's grasslands is under-investigated and the dearth of ecological understanding of how disturbance by fire and grazing shapes these grasslands stems from a perception that disturbance shaped Malagasy grasslands only after human arrival. However, worldwide, fire and grazing shape tropical grasslands over ecological and evolutionary timescales, and it is curious Madagascar should be a global anomaly. We examined the functional and community ecology of Madagascar's grasslands across 71 communities in the Central Highlands. Combining multivariate abundance models of community composition and clustering of grass functional traits, we identified distinct grass assemblages each shaped by fire or grazing. The fire-maintained assemblage is primarily composed of tall caespitose species with narrow leaves and low bulk density. By contrast, the grazer-maintained assemblage is characterized by mat-forming, high bulk density grasses with wide leaves. Within each assemblage, levels of endemism, diversity and grass ages support these as ancient assemblages. Grazer-dependent grasses can only have co-evolved with a now-extinct megafauna. Ironically, the human introduction of cattle probably introduced a megafaunal substitute facilitating modern day persistence of a grazer-maintained grass assemblage in an otherwise defaunated landscape, where these landscapes now support the livelihoods of millions of people

Permafrost Measurements Best Practice: GCW’s contribution to standardization of global observations

The Global Cryosphere Watch (GCW), in the context of the framework of the World Meteorological Organization (WMO), published the Measurement of Cryospheric Variables, Volume II of the Guide to Instruments and Methods of Observation in 2018, in which best practice for observations of snow parameters was included. As a follow-up effort, measurement best practices for the other cryosphere components are under development, including permafrost and seasonally frozen ground. The measurement best practice for permafrost aims to define reference methods for the configuration and ongoing operation of stations for in situ observations in high mountains and polar regions. It will: address gaps in the existing permafrost monitoring systems, define methods for improving traceability and comparability, recommend instrumental characteristics and provide measurements uncertainty evaluation. A further objective is to support capacity building of countries in terms of developing a permafrost observation network. A Task Team within the framework of GCW was established, to lead the development and publication of a complete guide to the measurements of permafrost variables. The documents in preparation will be coordinated with the ongoing revision of Products and Requirements of the Global Climate Observing System (GCOS) Permafrost Essential Climate Variable (ECV), including existing variables measured by the GTN-P (Global Terrestrial Network for Permafrost). Further, the needs of developing Essential Arctic Variables (EAV) and Shared Arctic Variables (SAV) identified at the Arctic Observing Summit (AOS) are considered. The work will be based on existing methodologies, promoting and recommending methods to improve data reliability and traceability, also for the implementation of new stations

Gut Microbiome Perturbations Induced by Bacterial Infection Affect Arsenic Biotransformation

Exposure to arsenic affects large human populations worldwide and has been associated with a long list of human diseases, including skin, bladder, lung, and liver cancers, diabetes, and cardiovascular disorders. In addition, there are large individual differences in susceptibility to arsenic-induced diseases, which are frequently associated with different patterns of arsenic metabolism. Several underlying mechanisms, such as genetic polymorphisms and epigenetics, have been proposed, as these factors closely impact the individuals’ capacity to metabolize arsenic. In this context, the role of the gut microbiome in directly metabolizing arsenic and triggering systemic responses in diverse organs raises the possibility that perturbations of the gut microbial communities affect the spectrum of metabolized arsenic species and subsequent toxicological effects. In this study, we used an animal model with an altered gut microbiome induced by bacterial infection, 16S rRNA gene sequencing, and inductively coupled plasma mass spectrometry-based arsenic speciation to examine the effect of gut microbiome perturbations on the biotransformation of arsenic. Metagenomics sequencing revealed that bacterial infection significantly perturbed the gut microbiome composition in C57BL/6 mice, which in turn resulted in altered spectra of arsenic metabolites in urine, with inorganic arsenic species and methylated and thiolated arsenic being perturbed. These data clearly illustrated that gut microbiome phenotypes significantly affected arsenic metabolic reactions, including reduction, methylation, and thiolation. These findings improve our understanding of how infectious diseases and environmental exposure interact and may also provide novel insight regarding the gut microbiome composition as a new risk factor of individual susceptibility to environmental chemicals.National Institute of Environmental Health Sciences (Massachusetts Institute of Technology. Center for Environmental Health Sciences Grant P30 ES002109)National Institute of Environmental Health Sciences (University of North Carolina. Center for Environmental Health and Susceptibility Grant P30 ES010126

Cross-Hemisphere Study Reveals Geographically Ubiquitous, Plastic-Specific Bacteria Emerging from the Rare and Unexplored Biosphere

While it is now appreciated that the millions of tons of plastic pollution travelling through marine systems carry complex communities of microorganisms, it is still unknown to what extent these biofilm communities are specific to the plastic or selected by the surrounding ecosystem. To address this, we characterized and compared the microbial communities of microplastic particles, nonplastic (natural and wax) particles, and the surrounding waters from three marine ecosystems (the Baltic, Sargasso and Mediterranean seas) using high-throughput 16S rRNA gene sequencing. We found that biofilm communities on microplastic and nonplastic particles were highly similar to one another across this broad geographical range. The similar temperature and salinity profiles of the Sargasso and Mediterranean seas, compared to the Baltic Sea, were reflected in the biofilm communities. We identified plastic-specific operational taxonomic units (OTUs) that were not detected on nonplastic particles or in the surrounding waters. Twenty-six of the plastic-specific OTUs were geographically ubiquitous across all sampled locations. These geographically ubiquitous plastic-specific OTUs were mostly low-abundance members of their biofilm communities and often represented uncultured members of marine ecosystems. These results demonstrate the potential for plastics to be a reservoir of rare and understudied microbes, thus warranting further investigations into the dynamics and role of these microbes in marine ecosystems

The support and information needs of adolescents and young adults with cancer when active treatment ends

Background: The end of active treatment is a period of high stress for young people with cancer, but limited literature exists about their information and support needs during this phase. This study aimed to understand the needs of young people with cancer, how these needs are currently being met, and how best to provide information and support at the end of active treatment. Methods: This was a multi-stage, mixed methods study exploring the end of treatment experience from the perspectives of young people, and the healthcare professionals caring for them. Semi-structured interviews were undertaken with healthcare professionals, which informed a survey administered nationally. Subsequently, semi-structured interviews were conducted with young people. These combined results informed a co-design workshop to develop recommendations. Results: Telephone interviews were conducted with 12 healthcare professionals and 49 completed the online survey. A total of 11 young people aged 19-26 years (female = 8; 73%) were interviewed. The stakeholder workshop was attended by both healthcare professionals (n = 8) and young people (n = 3). At the end of treatment young people experience numerous ongoing physical issues including pain, fatigue and insomnia; in addition to a range of psychosocial and emotional issues including anxiety, fear of recurrence and isolation. The top three priorities for end of treatment care were: earlier provision and preparation around on-going impact of cancer and cancer treatment; standardised and continued follow-up of young people's emotional well-being; and development of more information and resources specific to young people. Conclusion: The access and availability of appropriate information and sources of support at the end of treatment is variable and inequitable. Young people's needs would be more effectively met by timely, structured and accessible information, and support provision at the end of treatment to both prepare and enable adaptation across their transition to living with and beyond cancer. This will require both organisational and practical adjustments in care delivery, in addition to a renewed and updated understanding of what the 'end of treatment' transition process means

Chytrid fungus infection in zebrafish demonstrates that the pathogen can parasitize non-amphibian vertebrate hosts.

Aquatic chytrid fungi threaten amphibian biodiversity worldwide owing to their ability to rapidly expand their geographical distributions and to infect a wide range of hosts. Combating this risk requires an understanding of chytrid host range to identify potential reservoirs of infection and to safeguard uninfected regions through enhanced biosecurity. Here we extend our knowledge on the host range of the chytrid Batrachochytrium dendrobatidis by demonstrating infection of a non-amphibian vertebrate host, the zebrafish. We observe dose-dependent mortality and show that chytrid can infect and proliferate on zebrafish tissue. We also show that infection phenotypes (fin erosion, cell apoptosis and muscle degeneration) are direct symptoms of infection. Successful infection is dependent on disrupting the zebrafish microbiome, highlighting that, as is widely found in amphibians, commensal bacteria confer protection against this pathogen. Collectively, our findings greatly expand the limited tool kit available to study pathogenesis and host response to chytrid infection