Being conductor of the orchestra: An exploration of district nursing leadership

Chris McVittie - ORCID 0000-0003-0657-7524 https://orcid.org/0000-0003-0657-7524Margaret Smith - ORCID 0000-0003-2944-5348 https://orcid.org/0000-0003-2944-5348The purpose of the present study was to gain insight into how district nurses understand their leadership role. Data were generated through interviews and audio-journals and analysed using interpretive phenomenological analysis. Findings suggested that district nurses managing teams and caseloads experienced a burden of responsibility. Being creative problem solvers, they adopted facilitative ways of engaging with patients but directive approaches to team management. District nurses sharing leadership with multidisciplinary colleagues did not appear to experience this burden. Their leadership drew on their facilitative approaches to care-giving. If nurses enabled, rather than directed teams, they could create a context for developing autonomy and growth, easing the burden of responsibility.https://doi.org/10.12968/bjcn.2020.25.5.21425pubpub

Hidden Interactions in the Economics of Peace and Conflict

Peer reviewedPostprin

Cell-Penetrating Peptides as a Tool for the Cellular Uptake of a Genetically Modified Nitroreductase for use in Directed Enzyme Prodrug Therapy

Directed enzyme prodrug therapy (DEPT) involves the delivery of a prodrug-activating enzyme to a solid tumour site, followed by the subsequent activation of an administered prodrug. One of the most studied enzyme–prodrug combinations is the nitroreductase from Escherichia coli (NfnB) with the prodrug CB1954 [5-(aziridin-1-yl)-2,4-dinitro-benzamide]. One of the major issues faced by DEPT is the ability to successfully internalize the enzyme into the target cells. NfnB has previously been genetically modified to contain cysteine residues (NfnB-Cys) which bind to gold nanoparticles for a novel DEPT therapy called magnetic nanoparticle directed enzyme prodrug therapy (MNDEPT). One cellular internalisation method is the use of cell-penetrating peptides (CPPs), which aid cellular internalization of cargo. Here the cell-penetrating peptides: HR9 and Pep-1 were tested for their ability to conjugate with NfnB-Cys. The conjugates were further tested for their potential use in MNDEPT, as well as conjugating with the delivery vector intended for use in MNDEPT and tested for the vectors capability to penetrate into cells

Identification of an unusual Brucella strain (BO2) from a lung biopsy in a 52 year-old patient with chronic destructive pneumonia

<p>Abstract</p> <p>Background</p> <p>Brucellosis is primarily a zoonotic disease caused by <it>Brucella </it>species. There are currently ten <it>Brucella </it>spp. including the recently identified novel <it>B. inopinata </it>sp. isolated from a wound associated with a breast implant infection. In this study we report on the identification of an unusual <it>Brucella</it>-like strain (BO2) isolated from a lung biopsy in a 52-year-old patient in Australia with a clinical history of chronic destructive pneumonia.</p> <p>Results</p> <p>Standard biochemical profiles confirmed that the unusual strain was a member of the <it>Brucella </it>genus and the full-length 16S rRNA gene sequence was 100% identical to the recently identified <it>B. inopinata </it>sp. nov. (type strain BO1^T). Additional sequence analysis of the <it>recA, omp2a </it>and <it>2b </it>genes; and multiple locus sequence analysis (MLSA) demonstrated that strain BO2 exhibited significant similarity to the <it>B. inopinata </it>sp. compared to any of the other <it>Brucella </it>or <it>Ochrobactrum </it>species. Genotyping based on multiple-locus variable-number tandem repeat analysis (MLVA) established that the BO2 and BO1^Tstrains form a distinct phylogenetic cluster separate from the other <it>Brucella </it>spp.</p> <p>Conclusion</p> <p>Based on these molecular and microbiological characterizations, we propose that the BO2 strain is a novel lineage of the newly described <it>B. inopinata </it>species.</p

Physical activity, mental health and well-being of adults during initial COVID-19 containment strategies: A multi-country cross-sectional analysis

ObjectivesTo assess physical activity (PA), mental health and well-being of adults in the United Kingdom (UK), Ireland, New Zealand and Australia during the initial stages of National governments’ Coronavirus disease (COVID-19) containment responses.DesignObservational, cross-sectional.MethodsAn online survey was disseminated to adults (n = 8,425; 44.5 ± 14.8y) residing in the UK, Ireland, New Zealand and Australia within the first 2-6 weeks of government-mandated COVID-19 restrictions. Main outcome measures included: Stages of Change scale for exercise behaviour change; International Physical Activity Questionnaire (short-form); World Health Organisation-5 Well-being Index; and the Depression Anxiety and Stress Scale-9.ResultsParticipants who reported a negative change in exercise behaviour from before initial COVID-19 restrictions to during the initial COVID-19 restrictions demonstrated poorer mental health and well-being compared to those demonstrating either a positive-or no change in their exercise behaviour (p < 0.001). Whilst women reported more positive changes in exercise behaviour, young people (18-29y) reported more negative changes (both p < 0.001). Individuals who had more positive exercise behaviours reported better mental health and well-being (p < 0.001). Although there were no differences in PA between countries, individuals in New Zealand reported better mental health and well-being (p < 0.001).ConclusionThe initial COVID-19 restrictions have differentially impacted upon PA habits of individuals based upon their age and sex, and therefore have important implications for international policy and guideline recommendations. Public health interventions that encourage PA should target specific groups (e.g., men, young adults) who are most vulnerable to the negative effects of physical distancing and/or self-isolation

Phenotype and immune function of lymph node and peripheral blood CLL cells are linked to transendothelial migration

everal lines of evidence suggest that homing of tumor cells to lymphoid tissue contributes to disease progression in chronic lymphocytic leukemia (CLL). Here, we demonstrate that lymph node (LN)-derived CLL cells possess a distinct phenotype, and exhibit enhanced capacity for T-cell activation and superior immune synapse formation when compared with paired peripheral blood (PB) samples. LN-derived CLL cells manifest a proliferative, CXCR4(dim)CD5(bright) phenotype compared with those in the PB and higher expression of T-cell activation molecules including CD80, CD86, and HLA-D-related (DR). In addition, LN-CLL cells have higher expression of α4β1 (CD49d) which, as well as being a co-stimulatory molecule, is required for CLL cells to undergo transendothelial migration (TEM) and enter the proliferation centers of the LNs. Using an in vitro system that models circulation and TEM, we showed that the small population of CLL cells that migrate are CXCR4(dim)CD5(bright) with higher CD49d, CD80, CD86, and HLA-DR compared with those that remain circulating; a phenotype strikingly similar to LN-derived CLL cells. Furthermore, sorted CD49d(hi) CLL cells showed an enhanced capacity to activate T cells compared with CD49d(lo) subpopulations from the same patient. Thus, although PB-CLL cells have a reduced capacity to form immune synapses and activate CD4(+) T cells, this was not the case for LN-CLL cells or those with the propensity to undergo TEM. Taken together, our study suggests that CLL cell immunologic function is not only modulated by microenvironmental interactions but is also a feature of a subpopulation of PB-CLL cells that are primed for lymphoid tissue homing and interaction with T cells