Changes in Dry State Hemoglobin over Time Do Not Increase the Potential for Oxidative DNA Damage in Dried Blood

BACKGROUND: Hemoglobin (Hb) is the iron-containing oxygen transport protein present in the red blood cells of vertebrates. Ancient DNA and forensic scientists are particularly interested in Hb reactions in the dry state because both regularly encounter aged, dried bloodstains. The DNA in such stains may be oxidatively damaged and, in theory, may be deteriorated by the presence of Hb. To understand the nature of the oxidative systems potentially available to degrade DNA in the presence of dried Hb, we need to determine what molecular species Hb forms over time. These species will determine what type of iron (i.e. Fe(2+)/Fe(3+)/Fe(4+)) is available to participate in further chemical reactions. The availability of "free" iron will affect the ability of the system to undergo Fenton-type reactions which generate the highly reactive hydroxyl radical (OH*). The OH* can directly damage DNA. METHODOLOGY/PRINCIPAL FINDINGS: Oxygenated Hb (oxyHb) converts over time to oxidized Hb (metHb), but this happens more quickly in the dry state than in the hydrated state, as shown by monitoring stabilized oxyHb. In addition, dry state oxyHb converts into at least one other unknown species other than metHb. Although "free" iron was detectable as both Fe(2+) and Fe(3+) in dry and hydrated oxyHb and metHb, the amount of ions detected did not increase over time. There was no evidence that Hb becomes more prone to generating OH* as it ages in either the hydrated or dry states. CONCLUSIONS: The Hb molecule in the dried state undergoes oxidative changes and releases reactive Fe(II) cations. These changes, however, do not appear to increase the ability of Hb to act as a more aggressive Fenton reagent over time. Nevertheless, the presence of Hb in the vicinity of DNA in dried bloodstains creates the opportunity for OH*-induced oxidative damage to the deoxyribose sugar and the DNA nucleobases

Ward based feeding and swallowing training.

Conference posterTITLE OF PAPER: WARD BASED FEEDING AND SWALLOWING TRAINING KEYWORDS: DYSPHAGIA, EVIDENCE BASE WHY THE STUDY WAS UNDERTAKEN This paper summarises the findings of the Northamptonshire Healthcare (NH) Feeding and Swallowing Training programme initiative. The results of the pilot study for this programme were presented at the Royal College of Speech and Language Therapists Conference in 2012. Speech and Language Therapists (SLTs) in the acute setting spend half of their time involved in providing feeding and swallowing care (Bixley, Blagdon, Dean, Langley & Stanton, 2011). As part of the multidisciplinary team, the overall aim of feeding and swallowing intervention is to help clients to meet their nutritional need. A recent Care Quality Commission (2011) report suggested that 51% of hospital trusts were not achieving this standard. Hospital based policies such as protected mealtimes highlight the importance of feeding within the acute sector. Inter professional guidelines (Boaden, 2006) and the evidence base for dysphagia management (Magnus, 2001) also support the use of specific feeding and swallowing training. However delivering comprehensive training within large hospitals is difficult using classroom based packages. Especially in environments where ward teams are large, staff teams change regularly and releasing staff for off ward training is difficult. The Northamptonshire feeding and swallowing programme was introduced to provide a sustainable swallowing training package that could overcome some of these difficulties, by providing training to nursing staff on the ward HOW THE STUDY WAS DONE The NHSLT team evaluated the impact of their innovative feeding and swallowing project by comparing the results of three ward based measures: B1, B2 and B3. The research was carried out on four acute wards, one after another. It was conducted during the hospital wide, one hour protected lunchtime slot. In each of the wards observational and questionnaire measurements (B1) were taken before implementation of a two week, eight day, training package. After the ward based training had occurred two further evaluations were conducted, one immediately after the training package had been delivered (B2) and one two weeks after the programme had been completed (B3). Observational measures were qualitative and recorded general impressions of the feeding practise on the ward. Questionnaire measurements were both quantitative and qualitative and were designed to identify what ward staff understood about feeding and swallowing difficulties. WHAT WAS FOUND Over the course of the ten month research project, twenty four hours of training was provided for fifty four people, on four different wards. Training was provided to 31 health care assistants, 17 nurses, 3 student nurses and 2 assistants and 2 others .Statistical analysis of the ward based knowledge questionnaires suggested that there was a significant difference between the scores obtained in B1 and B2 and B3 (Kruskal Wallis H (2) = 15.537, p=0.014 with a mean rank of 18.64 for B1, 34.83 for B2 and 37.78 for B3). These findings suggest that the feeding training programme had resulted in a measurable difference in ward staff knowledge and this difference was evident after the training programme had been completed. IMPLICATIONS FOR FUTURE POLICY AND PRACTICE The results of this study suggest that ward based feeding programmes are an effective way to deliver training. This type of training targets people who do not normally attend swallowing training courses because they cannot be released from their work. It also means that training can be individualised to the needs of different wards and staff members. This type of training delivery may be a valuable supplement or alternative to classroom based teaching programmes. • REFERENCES Blagdon, B., Bixley, M., Levis, N., Bird, L., Hood, G. & Murphy, K. (2012). Taking dysphagia management out of the classroom: A ward based feeding and swallowing project. Royal College of Speech and Language Therapists Conference, Driving transformation Using Evidence Based Practice, 52. Bixley, M., Blagdon, B., Dean, M., Langley, J. & Stanton, D. (2011). In search of consensus on aphasia management. Royal College of Speech and Language Therapists Bulletin, October, 18-20. Boaden, E. & Davies, S., Storey, L., & Watkins, C. (2006). Interprofessional Dysphagia Framework. www.uclan.aca.uk/facs/health/nursing/research/groups/stroke Care Quality Commission (2011). Dignity and Nutrition Inspection Programme. Newcastle upon Tyne: Care Quality Commission. Magnus, V. (2001). Dysphagia training for nurses in an acute hospital setting – a pragmatic approach. International Journal of Language and Communication Disorders, 36, 375-378

Enhancing the early student experience

This paper is concerned with identifying how the early student experience can be enhanced in order to improve levels of student retention and achievement. The early student experience is the focus of this project as the literature has consistently declared the first year to be the most critical in shaping persistence decisions. Programme managers of courses with high and low retention rates have been interviewed to identify activities that appear to be associated with good retention rates. The results show that there are similarities in the way programmes with high retention are run, with these features not being prevalent on programmes with low retention. Recommendations of activities that appear likely to enhance the early student experience are provided

Exploring the resilience of wheat crops grown in short rotations through minimising the build-up of an important soil-borne fungal pathogen

Given the increasing demand for wheat which is forecast, cropping of wheat in short rotations will likely remain a common practice. However, in temperate wheat growing regions the soil-borne fungal pathogen Gaeumannomyces tritici becomes a major constraint on productivity. In cultivar rotation field experiments on the Rothamsted Farm we demonstrated a substantial reduction in take-all disease and grain yield increases of up to 2.4 tonnes/ha when a low take-all inoculum building wheat cultivar was grown in the first year of wheat cropping. Phenotyping of 71 modern elite wheat cultivars for the take-all inoculum build-up trait across six diverse trial sites identified a few cultivars which exhibited a consistent lowering of take-all inoculum build-up. However, there was also evidence of a significant interaction effect between trial site and cultivar when a pooled Residual Maximum Likelihood (REML) procedure was conducted. There was no evidence of an unusual rooting phenotype associated with take-all inoculum build-up in two independent field experiments and a sand column experiment. Together our results highlight the complex interactions between wheat genotype, environmental conditions and take-all inoculum build-up and further work is required to determine the underlying genetic and mechanistic basis of this important phenomenon