Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

Bridging the theory–practice gap in student nurse training: an evaluation of a personal and professional development programme

A key challenge facing pre-registration nurse educators is to turn out students who are fit for practice by the end of their training (United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1999). This includes developing their understanding of professionalism (Department of Health, 2003; Nursing and Midwifery Council, 2004; 2007). This paper provides an evaluation of a special personal and professional development scheme for mental health student nurses implemented to improve the learning and development process. The scheme required that in addition to individual meetings with personal tutors, students would meet in small groups of 12–15, every six weeks, facilitated by their personal tutor and a clinician. The meetings provided a space for students to discuss nursing topics, their clinical experiences and performance to improve their understanding of professional standards in their role transition. The outcome was that over 80% of the respondents were satisfied with the structure, facilitation methods, contents, group size and the time allocated for the meetings. They also reported an increase in knowledge and level of understanding, awareness of professional expectations, making better theory–practice links of learning and becoming more self-aware. The authors suggest that nurse training departments should collaborate with their clinical partners and adopt a similar framework to help bridge the theory–practice gap and enhance the transition process from student to qualified practitioner