An exploration of the professional relationship between Nurse Academic Personal Tutors and Student Nurse Tutees, using the critical lens of Lefebvre and Bourdieu in undergraduate nurse education in higher education

The role of the Personal Tutor (PT) in undergraduate nurse education (UNE) is important, with a key focus on student support, progress monitoring and professional learning. Changes in Higher Education (HE) in England over the last 40 years, characterised by the neoliberalisation of universities and increasing student numbers have led to many challenges for nurse academic personal tutors (NAPT) and student nurse (SN) tutees, including inconsistencies within this relationship. The overall aim of this study was therefore to critically explore and understand the NAPT’s and SN`s perceptions of the professional relationship in personal tutoring. A qualitative research approach was taken whereby 6 NAPT and 6 SN participants undertook a Self-Interview during the COVID-19 global pandemic from January to April 2021. Data was processed by responsive listening and typed narrative capturing noises, pauses and silence and was analysed using the critical lens of Lefebvre`s Rhythmanalysis and Bourdieu`s field of power. The analysis involved the creation of two Think Tables to facilitate plugging the theoretical concepts into the data and presentation of the findings. Rhythmanalysis of the data revealed the dominance of fast pace, repetitive linear rhythms created by the schedules of the undergraduate nursing course, including the apparent erosion of the NAPT role to that of a submissive neoliberal technician. Findings also illuminated arrhythmic tension in the balance of power and investment in the professional relationship between the key players. However, complex moments of creative heterodox personal tutoring practice were captured as a professional pulse in the interchange between maintaining professional boundaries and acts of caring, compassion and kindness bound together as Professional Love, with the slowing of time to build and maintain professional relationships. In addition, the value of role modelling as a latent form of dressage and educational practice was a key contribution to this study. The arrhythmic impact of the sudden shift to online tutorials on the professional relationship during this time was also highlighted in relation to space, time and Dwelling in the personal tutorial. The study findings offer implications for personal tutoring practice including reconceptualising NAPT guidance and policies in the context of this role, the SN and neoliberal university. Findings also offer implications for research practice in the context of a Lefebvrian Pedagogy and the development of Self-Interview as a research method

Evaluation of a midwife-led, hospital based vaccination service for pregnant women.

Background: Vaccines against whooping cough (pertussis) and seasonal-influenza are recommended for pregnant women in England. Uptake however varies regionally and by ethnicity. Pregnant women are traditionally vaccinated in primary care, though some hospitals now offer vaccines through antenatal clinics. This mixed-methods evaluation describes the demographic characteristics of women seen in a hospital midwife-led antenatal vaccine clinic and explores vaccine decision making. Methods: Descriptive statistics of women seen in a London hospital's midwife-led vaccine clinic were generated from electronic routine maternity records, including data on ethnicity, parity, age and deprivation indices. Reasons for vaccine decline given by women to midwives were categorized by themes. Qualitative interviews of women seen in the clinic were also undertaken. Results: Between 1st April 2017 and 31st March 2018 the vaccine clinic saw 1501 pregnant women. Of these, 83% received pertussis vaccine and (during flu season) 51% received influenza vaccine, from the clinic. Fewer Black Afro-Caribbean women seen by the clinic were vaccinated, compared to other ethnicities with only 68% receiving pertussis and 34% flu vaccines respectively (p < .05). Among all women delivering at the hospital over the year, 42%, (1334/3147) were vaccinated by the clinic. Qualitative interviews found that reassurance from healthcare professionals, particularly midwives, was the most important factor influencing maternal vaccine decisions. Conclusions: Midwife-led hospital clinics can offer an effective alternative to primary care provision for vaccines in pregnancy. Consistent with previous work, vaccine uptake varied by ethnicity. Midwives play a key role in the provision of vaccine services and influence women's vaccine decisions

The malaria parasite cyclic GMP-dependent protein kinase plays a central role in blood-stage schizogony.

A role for the Plasmodium falciparum cyclic GMP (cGMP)-dependent protein kinase (PfPKG) in gametogenesis in the malaria parasite was elucidated previously. In the present study we examined the role of PfPKG in the asexual blood-stage of the parasite life cycle, the stage that causes malaria pathology. A specific PKG inhibitor (compound 1, a trisubstituted pyrrole) prevented the progression of P. falciparum schizonts through to ring stages in erythrocyte invasion assays. Addition of compound 1 to ring-stage parasites allowed normal development up to 30 h postinvasion, and segmented schizonts were able to form. However, synchronized schizonts treated with compound 1 for > or =6 h became large and dysmorphic and were unable to rupture or liberate merozoites. To conclusively demonstrate that the effect of compound 1 on schizogony was due to its selective action on PfPKG, we utilized genetically manipulated P. falciparum parasites expressing a compound 1-insensitive PfPKG. The mutant parasites were able to complete schizogony in the presence of compound 1 but not in the presence of the broad-spectrum protein kinase inhibitor staurosporine. This shows that PfPKG is the primary target of compound 1 during schizogony and provides direct evidence of a role for PfPKG in this process. Discovery of essential roles for the P. falciparum PKG in both asexual and sexual development demonstrates that cGMP signaling is a key regulator of both of these crucial life cycle phases and defines this molecule as an exciting potential drug target for both therapeutic and transmission blocking action against malaria

Expanded directly binds conserved regions of Fat to restrain growth via the Hippo pathway

The Hippo pathway is a conserved and critical regulator of tissue growth. The FERM protein Expanded is a key signaling hub that promotes activation of the Hippo pathway, thereby inhibiting the transcriptional co-activator Yorkie. Previous work identified the polarity determinant Crumbs as a primary regulator of Expanded. Here, we show that the giant cadherin Fat also regulates Expanded directly and independently of Crumbs. We show that direct binding between Expanded and a highly conserved region of the Fat cytoplasmic domain recruits Expanded to the apicolateral junctional zone and stabilizes Expanded. In vivo deletion of Expanded binding regions in Fat causes loss of apical Expanded and promotes tissue overgrowth. Unexpectedly, we find Fat can bind its ligand Dachsous via interactions of their cytoplasmic domains, in addition to the known extracellular interactions. Importantly, Expanded is stabilized by Fat independently of Dachsous binding. These data provide new mechanistic insights into how Fat regulates Expanded, and how Hippo signaling is regulated during organ growth

Detection of a CMB decrement towards a cluster of mJy radiosources

We present the results of radio, optical and near-infrared observations of the field of TOC J0233.3+3021, a cluster of milliJansky radiosources from the TexOx Cluster survey. In an observation of this field with the Ryle Telescope (RT) at 15 GHz, we measure a decrement in the cosmic microwave background (CMB) of $-675 \pm 95 \mu$Jy on the RT's $\approx$ 0.65 k$\lambda$ baseline. Using optical and infrared imaging with the McDonald 2.7-m Smith Reflector, Calar Alto 3.5-m telescope and UKIRT, we identify the host galaxies of five of the radiosources and measure magnitudes of $R \approx 24$, $J \approx 20$, $K \approx 18$. The CMB decrement is consistent with the Sunyaev-Zel'dovich (SZ) effect of a massive cluster of galaxies, which if modelled as a spherical King profile of core radius $\theta_C = 20^{\prime\prime}$ has a central temperature decrement of $900 \mu$K. The magnitudes and colours of the galaxies are consistent with those of old ellipticals at $z \sim 1$. We therefore conclude that TOC J0233.3+3021 is a massive, high redshift cluster. These observations add to the growing evidence for a significant population of massive clusters at high redshift, and demonstrate the effectiveness of combining searches for AGN `signposts' to clusters with the redshift-independence of the SZ effect.Comment: Six pages; accepted for publication in MNRAS. Version with full-resolution UV plot available from http://www.mrao.cam.ac.uk/~garret/MB185.p

Differences in Vascular Outcomes and Sedentary Behaviour in Pre- and Post-Menopausal Women

Introduction: Vascular ageing, characterized by endothelial dysfunction and atherosclerosis is an integral component of cardiovascular disease (CVD) development. The menopause and its associated reduction in oestrogen accelerates female vascular aging. Sedentary behaviour (SB) and physical activity (PA) levels modify vascular risk and may further exacerbate aging induced pathological arterial remodelling. The aim of this study was to examine the differences in vascular artery health, PA and SB in pre- and post-menopausal women. Methodology: Thirty-three female adults were recruited and grouped according to whether they were pre-menopausal (PRE-M; 31.410.7 years, BMI 24.76.7kg/m2) or post-menopausal (POST-M; 55.37.3 years, BMI 25.54.8kg/m2). Systolic (SBP) and diastolic (DBP) blood pressure was measured following 30 minutes supine rest. Vascular ultrasound was used to assess carotid artery intima media thickness (cIMT) and brachial artery vasodilator response to 5 minutes distal limb occlusion. Carotid artery reactivity (CAR%) to a cold pressor test was assessed and pulse wave velocity (PWV) was calculated using applanation tonometry. VO2max was determined by a cycling ramp protocol to volitional exhaustion. Habitual SB and PA were measured over 7 days using an inclinometer and accelerometry respectively. Group differences were determined using independent t-tests. Results: Significant differences (p=<0.01) were observed for SBP (107±7mmHg; 122±15mmHg), DBP (64±6mmHg; 70±6mmHg) and cIMT (0.58±0.07mm; 0.72±0.08mm) between PRE-M and POST-M women respectively. No significant differences were found between groups for PWV (PRE-M, 5.3±0.8cm/s; POST-M, 6.1±1.6cm/s) or CAR% (PRE-M; 1.56±2.4%, POST-M; 1.48±2.1%). VO2max was higher in PRE-M (35.8±6.7mL/kg/min; 25.3±4.8mL/kg/min; p<0.001). Neither total PA time (PRE-M; 265.4±72mins/d , POST-M; 317±93.2mins/d) nor daily SB differed significantly between groups (PRE-M, 65.5±16%; POST-M, 53.9±21.3%). Coclusion: Our findings confirm that SBP, DBP and cIMT increase with age. Despite a lower VO2max in POST-M, PA and SB patterns did not differ between PRE- and POST-M women. Our findings may indicate that VO2max, and not PA or SB level plays an important role in mediating some markers of vascular aging in post menopausal women, however further research is needed to confirm this

The Effect of Exercise During Pregnancy on Maternal and Offspring Vascular Outcomes: a Pilot Study

The aim of this pilot study is to obtain estimates for the change in maternal cerebrovascular (primary) and offspring vascular structure (secondary) during healthy pregnancy that includes structured exercise. Eighteen pregnant women self-assigned to a moderate-intensity aerobic exercise intervention or a control group. Maternal cerebral blood flow (CBF) at the middle cerebral artery, cerebro- and peripheral-vascular function was assessed at the end of each trimester. Offspring carotid artery intima-media thickness (IMT) was measured within 12 weeks of birth. For exploratory purposes, we performed statistical analysis to provide estimates of the change for primary and secondary outcome variables. Maternal CBF reduced (− 8 cm s−1 [− 14 to − 2]) with evidence of change to cerebral autoregulation (normalised gain: 0.12 %cm s−1 % mmHg−1 mmHg/% [− 0.18 to 0.40]) during pregnancy. Offspring carotid IMT was smaller in the exercise group (− 0.04 mm [− 0.12–0.03]) compared with controls. Based upon this data, a sample size of 33 and 57 in each group is required for low-frequency normalised gain and offspring IMT, respectively. This would provide 90% power to detect statistically significant (P < 0.05) between group differences in a randomised controlled trial. CBF is reduced in pregnancy, possibly due to reduced vascular resistance and altered maternal cerebral autoregulation. Maternal exercise had negligible effects on cerebrovascular adaptation to pregnancy, but we observed lower offspring carotid artery wall thickness following maternal exercise. Our directional findings and sample size estimations should be explored in a fully powered randomised control trial. Clinical trial registration: The trial was registered on March 14th at https://register.clinicaltrials.gov (NCT03079258). Participant enrolment began on 3rd April 2016. Keywords Pregnancy . Exercise . Cerebrovascular function . Endothelial function . Offsprin

Regular moderate intensity aerobic exercise does not affect vascular outcomes during pregnancy: A pilot study

Abstract. (Maximum of 250 words) Introduction: Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality during pregnancy attributed to progressive vascular impairments. Regular exercise has been shown to improve vascular outcomes. The aim of this pilot study was to determine the impact of a 6-month exercise intervention on vascular outcomes in previously inactive pregnant women. Methods: Ten healthy pregnant women were recruited to a control (CONT; N=6 330.5 years, BMI 22.4kg/m2) or exercise group (EX; N=4 31.5 0.6 years, BMI 23.82.1kg/m2) at 13-15 weeks gestation. Ultrasound was used to assess brachial and femoral flow mediated dilation (bFMD; fFMD respectively) at the end of trimester 1(T1), 2(T2) and 3(T3). Aerobic capacity was estimated using the Astrand submaximal cycling protocol. Physical activity (PA) was measured over 7 days using accelerometry. The exercise intervention consisted of 3x15 minute weekly exercise sessions in trimester-2 (T2), progressing to 4x30 minutes in trimester-3 (T3). Data were analyzed for main effects of group and time using repeated measures ANOVA. Results: There were no time, group or interaction effects for BFMD (T1: 9.22.1%, T2:6.70.9%, T3: 95%, P=0.76), FFMD (T1, 6.53.4%, T2, 6.22%, T3, 2.41.9%, P=0.18). No differences in aerobic capacity were evident (T1, 47.4±5ml/kg, T2, 43.4±3.3ml/kg, T3, 39.1±3.5ml/kg, p=0.22). No differences were observed for physical activity (T1, 330±87mins/d; T2, 296±52mins/d; T3, 271±16mins/d. Conclusion: Our findings suggest that vascular outcomes are not impacted upon exercising during trimesters 2 and 3 of pregnancy. It is plausible that the hormonally induced hemodynamic adaptations which occur during pregnancy cannot be overridden by moderate intensity exercise

Women’s views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: A multi-methods study in the UK.

BACKGROUND: COVID-19 vaccines are the cornerstone of the pandemic response and now advised for pregnant women in the United Kingdom(UK) however COVID-19 vaccine acceptance among pregnant women is unknown. METHODS: An online survey and semi-structured interviews were used to investigate pregnant women’s views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. 1,181 women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August–11th October 2020. Ten women were interviewed. RESULTS: The majority of women surveyed (81.2%) reported that they would ‘definitely’ or were ‘leaning towards’ accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p<0.005) and for their babies (69.9%, p<0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant, pregnant and for their babies compared to women from White ethnic groups (p<0.005). Women from lower-income households, aged under 25-years, and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant, pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant, pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. CONCLUSION: Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed