Commentary: A wellbeing champion and the role of self-reflective practice for ICU nurses during COVID-19 and beyond

The purpose of this commentary is to highlight the importance of an intensive care unit (ICU) wellbeing champion, who promotes self-reflective practice and self-care to protect staff wellbeing. The wellbeing champion provides peer-to-peer support, delivers psychological first aid and through the “Look, Listen and Link” approach, signposts staff towards professional assistance when needed. Our ICU nominated a wellbeing champion from within the nursing team to take a bottom-up approach to staff wellbeing during the COVID-19 crisis where the stress levels in ICU are notably high.N/

Abandoning ‘a Lifetime of Habits’ to Avoid the ‘Sins of the Past’: De-Congregating Institutions with Deeply Ingrained Traditions

While many studies have identified the problem of reproducing small institutions in community settings, few have explored why. This article explores how staff preserve and defend institutionalised beliefs and practices in community settings. We apply the concepts of disruptive and defensive institutional work to analyse the findings of qualitative interviews at six Irish residential institutions that were identified as priority sites for a national de-congregation programme. Reflecting on their roles, staff conceptualised their practices as historical, traditional, and reflective of a bygone era. However, the findings indicate that it would be misleading to represent institutional practices as relics of the past. The programme offered an olive branch for staff members who wanted to distance themselves from a ‘lifetime of habits’ and ‘sins of the past’

A novel role for the fibrinogen Asn-Gly-Arg (NGR) motif in platelet function.

The integrin αIIbβ3 on resting platelets can bind to immobilised fibrinogen resulting in platelet spreading and activation but requires activation to bind to soluble fibrinogen. αIIbβ3 is known to interact with the general integrin-recognition motif RGD (arginine-glycine-aspartate) as well as the fibrinogen-specific γ-chain dodecapeptide; however, it is not known how fibrinogen binding triggers platelet activation. NGR (asparagine-glycine-arginine) is another integrin-recognition sequence present in fibrinogen and this study aims to determine if it plays a role in the interaction between fibrinogen and αIIbβ3. NGR-containing peptides inhibited resting platelet adhesion to fibrinogen with an IC50 of 175 µM but failed to inhibit the adhesion of activated platelets to fibrinogen (IC50\u3e 500 µM). Resting platelet adhesion to mutant fibrinogens lacking the NGR sequences was reduced compared to normal fibrinogen under both static and shear conditions (200 s⁻¹). However, pre-activated platelets were able to fully spread on all types of fibrinogen. Thus, the NGR motif in fibrinogen is the site that is primarily responsible for the interaction with resting αIIbβ3 and is responsible for triggering platelet activation

Anti-estrogen Resistance in Human Breast Tumors Is Driven by JAG1-NOTCH4-Dependent Cancer Stem Cell Activity

Breast cancers (BCs) typically express estrogen receptors (ERs) but frequently exhibit de novo or acquired resistance to hormonal therapies. Here, we show that short-term treatment with the anti-estrogens tamoxifen or fulvestrant decrease cell proliferation but increase BC stem cell (BCSC) activity through JAG1-NOTCH4 receptor activation both in patient-derived samples and xenograft (PDX) tumors. In support of this mechanism, we demonstrate that high ALDH1 predicts resistance in women treated with tamoxifen and that a NOTCH4/HES/HEY gene signature predicts for a poor response/prognosis in 2 ER+ patient cohorts. Targeting of NOTCH4 reverses the increase in Notch and BCSC activity induced by anti-estrogens. Importantly, in PDX tumors with acquired tamoxifen resistance, NOTCH4 inhibition reduced BCSC activity. Thus, we establish that BCSC and NOTCH4 activities predict both de novo and acquired tamoxifen resistance and that combining endocrine therapy with targeting JAG1-NOTCH4 overcomes resistance in human breast cancers

Attitudes and abilities of Irish famers to comply with Nitrates Directive (91/676/EEC) regulations

Eutrophication is defined as the process which occurs when the enrichment of water by high levels of nutrients of natural or anthropogenic source occurs, causing accelerated levels of algal and higher forms of plant life to grow disturbing water quality and ecosystem balance (OSPAR 2003). It is a widely recognised problem particularly from agricultural sources. With the foreseeable rise in human populations and the predicted increase in food demand, increased pressure on agricultural systems will occur and there is no doubt that this will amplify the levels of pollution in our surface water, groundwater and coastal areas. Nutrient input to water bodies arises from agricultural processes including the application of artificial and organic fertilisers containing nitrogen and phosphorous and run off from manure storage. Agriculture in Ireland utilizes 63% of the total land area, a total of 4.4 million hectares and agriculture is estimated to be the source of 82% of the nitrogen input to surface waters. The Nitrates Directive (91/676/EEC) plays a major role in improving the quality of freshwater and marine ecosystems by managing nutrient input sourced from agricultural land and thus preventing the occurrence of eutrophication. Principal to the functioning of the Nitrate Directive is the adherence of famers to codes of good practice and the reduction of fertiliser use on land. Given the high risk of pollution to the environment that can arise from a lack of compliance and understanding of legislation, the aim of this project was thus; To assess the implementation of the Nitrates Directive in Ireland by interviewing famers on their attitudes towards complying and abilities of adhering to the Nitrates Directives requirements. Famers were interviewed around the Republic of Ireland and results indicated that there is a very mixed level of compliance to regulations. The main factors influencing non compliance are; reductions in agricultural income and an overall lack of monitoring of farms by local authorities or state bodies (EPA), although monitoring is a requirement of the Nitrates Directive. An increase in monitoring levels must take place to ensure farmers are adhering to regulations, and furthermore, more knowledge sharing and discussion groups regarding the benefits of the Nitrates Directive must occur to heighten environmental awareness and compliance, with the aim to improve water quality in Ireland.Faculty of Scienc