Implementing an e-learning Masters programme for Practice Development

Introduction – The need for more effective person centred care has been propositioned for a number of years (Dewar and Nolan 2013; McCormack, Dewing and McCance, 2011; Dewing, 2004) and Practice Development (PD) has been viewed as one way to embed this into organisational culture (Manley, Sanders, Cardiff and Webster, 2011). More recently multiple policy reports echo this call (Age UK, 2012; Willis Commission on Nursing, 2012; Parliamentary Health Service Ombudsman, 2011). Joint work between the Department of Nursing and England Centre for Practice Development at Canterbury Christ Church University has validated an innovative Masters level programme in Practice Development, utilising workplace and e-learning approaches to facilitate creativity in the work setting. Aim: This paper will briefly describe the programme and then explore the experiences and challenges of implementing a work based and e-learning Masters Practice Development and Innovation programme. Approach: Practice Development is built on the key principles of person-centredness, shared values and vision, transforming individuals and culture through active learning, facilitation and engagement (McCormack, Manley, Titchen 2013). Thus, the approach to the Masters programme reflects these principles and utilises facilitation methods to enable practice development to transform the learner and work setting. As part of this process we, as lecturers, have been developing our own values and beliefs and expanded our knowledge and skills so that we can positively impact on the learner experience and work as learning partners. The programme is, therefore, evolving to embody these principles and enable learners to incorporate them into practice. The programme is built around ten core Practice Development/Innovation principles and the process of Active Learning, which will be expanded on in the presentation. Our vision is to make this programme accessible to regional, national and international learners. The work-based and e-learning approaches make this achievable but bring challenges to ensure that the programme reflects the principles of Practice Development from a distance. This is further complicated by facilitating a range of learners from diverse clinical areas, experiences and cultures who have often been exposed to traditional forms of learning. Thus, facilitating the learners to engage with the material, and incorporate it into their own practice setting, has led to careful consideration of materials for the learners to access. As the programme is progressing areas are emerging that need to be thoughtfully considered and addressed to ensure development of learning. Considerations: Initial themes starting to emerge are: increasing lecturer knowledge and skills around both Practice Development and different tools for e-learning, learners previous experience of facilitation and willingness to take responsibility for their own learning, challenges of promoting active learning approaches online , enabling achievement of Masters level learning outcomes with a distance approach, new ways of working for individuals plus the organisational views around supporting learners in practice. These require both lecturers and learners to be motivated to learn and devote time to engage with material and processes. However, it also requires lecturers and learners to make choices and reflect on activities to assess the relevance and usefulness to their situation. The programme encourages learners to be creative and examine issues differently which takes time to engage with and progress. Conclusion: Evaluation of this programme is in its infancy. A key learning point is that transforming practice through Practice Development and innovation in the workplace also involves transforming University views on learning, engagement and creativity

Influence of a montmorency cherry juice blend on indices of exercise-induced stress and upper respiratory tract symptoms following marathon running—a pilot investigation

Background: Prolonged exercise, such as marathon running, has been associated with an increase in respiratory mucosal inflammation. The aim of this pilot study was to examine the effects of Montmorency cherry juice on markers of stress, immunity and inflammation following a Marathon. Methods: Twenty recreational Marathon runners consumed either cherry juice (CJ) or placebo (PL) before and after a Marathon race. Markers of mucosal immunity secretory immunoglobulin A (sIgA), immunoglobulin G (IgG), salivary cortisol, inflammation (CRP) and self-reported incidence and severity of upper respiratory tract symptoms (URTS) were measured before and following the race. Results: All variables except secretory IgA and IgG concentrations in saliva showed a significant time effect (P < 0.01). Serum CRP showed a significant interaction and treatment effect (P < 0.01). The CRP increase at 24 and 48 h post-Marathon was lower (P < 0.01) in the CJ group compared to PL group. Mucosal immunity and salivary cortisol showed no interaction effect or treatment effect. The incidence and severity of URTS was significantly greater than baseline at 24 h and 48 h following the race in the PL group and was also greater than the CJ group (P < 0.05). No URTS were reported in the CJ group whereas 50 % of runners in the PL group reported URTS at 24 h and 48 h post-Marathon. Conclusions: This is the first study that provides encouraging evidence of the potential role of Montmorency cherries in reducing the development of URTS post-Marathon possibly caused by exercise-induced hyperventilation trauma, and/or other infectious and non-infectious factors

Biographical learning: a process for promoting person-centredness in nursing

Background: This paper explores biographical approaches to nurses’ learning. It builds on previous PhD research to consider the effects of such approaches, drawing on the experiences of learners who have recently completed biographical study, in their own words. Aims and objectives: The aim of the paper is to make sense of different forms of learning. The objectives are to identify how autobiographical approaches that involve people learning from their life stories can engage people to exert agency, or ownership, in their own lives by taking control of their learning plans. Design: This longitudinal study started with the first group of learners undertaking a biographical preparation module on an Applied BSc Health and Social Care programme. Methods: Research relating to nurses’ learning is considered, including a Swiss perspective, as well as the validity of the biographical approach to developing knowledge. The learners share stories of their learning in order to develop understanding and new insights into their own lives and those of others. Results: Different dimensions of learning including learning about self, learning to make a difference and processes of repair are revealed through the learners’ narrations. Conclusions: Engaging biographically, to make sense of different forms of learning, appears to be beneficial to more person-centred working. Implications for practice: •Introducing biographical elements into courses of study can benefit learners by helping them to make sense of who they are as learners and practitioners •Co-creating compelling spaces of learning can facilitate learners to exert agency within their own lives as well as help others to learn. By exerting agency we mean taking ownership of the learning revealed through the biographical work and taking it forward in positive ways to enhance person-centred care

Effects of Cycling Intensity on Acute Signaling Adaptations to 8-weeks Concurrent Training in Trained Cyclists

© 2022 Jones, Eddens, Kupusarevic, Simoes, Furber, Van Someren and Howatson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/This study examined whether the intensity of endurance stimuli modifies the adaptation in strength and endurance following concurrent training and whether the acute molecular response to concurrent exercise is affected by training status. Using a parallel group design, trained cyclists were randomized to either resistance exercise followed by moderate intensity continuous training (RES + MICT, n = 6), or resistance exercise followed by work matched high intensity interval training (RES + HIIT, n = 7), across an 8 weeks training programme. A single RES + MICT or RES + HIIT exercise stimulus was completed 1 week before and within 5 days of completing the training programme, to assess phosphorylation of protein kinases of the mTOR and AMPK signaling pathways. There were no main effects of time or group on the phosphorylation of protein kinases in response to concurrent exercise stimulus pre- and post-training intervention (p > 0.05). Main effects of time were observed for all maximal strength exercises; back-squat, split-squat, and calf-raise (p 0.05). Whilst preliminary data due to limited sample size the intensity of endurance activity had no effect on performance outcomes, following concurrent training. Further, the acute molecular response to a concurrent exercise stimulus was comparable before and after the training intervention, suggesting that training status had no effect on the molecular responses assessed.Peer reviewedFinal Published versio

The plasma bioavailability of nitrate and betanin from Beta vulgaris rubra in humans

Purpose: To evaluate the plasma bioavailability of betanin and nitric oxide (NOx) after consuming beetroot juice (BTJ) and whole beetroot (BF). BTJ and BF were also analysed for antioxidant capacity, polyphenol content (TPC) and betalain content. Methods: Ten healthy males consumed either 250 ml of BTJ, 300 g of BF or a placebo drink, in a randomised, crossover design. Venous plasma samples were collected pre (baseline), 1, 2, 3, 5 and 8 h post-ingestion. Betanin content in BTJ, BF and plasma was analysed with reverse-phase high-performance liquid chromatography (HPLC) and mass spectrometry detection (LCMS). Antioxidant capacity was estimated using the Trolox equivalent antioxidant capacity (TEAC) and polyphenol content using Folin–Ciocalteu colorimetric methods [gallic acid equivalents (GAE)] and betalain content spectrophotometrically. Results: TEAC was 11.4 ± 0.2 mmol/L for BTJ and 3.4 ± 0.4 μmol/g for BF. Both BTJ and BF contained a number of polyphenols (1606.9 ± 151 mg/GAE/L and 1.67 ± 0.1 mg/GAE/g, respectively), betacyanins (68.2 ± 0.4 mg/betanin equivalents/L and 19.6 ± 0.6 mg/betanin equivalents/100 g, respectively) and betaxanthins (41.7 ± 0.7 mg/indicaxanthin equivalents/L and 7.5 ± 0.2 mg/indicaxanthin equivalents/100 g, respectively). Despite high betanin contents in both BTJ (~194 mg) and BF (~66 mg), betanin could not be detected in the plasma at any time point post-ingestion. Plasma NOx was elevated above baseline for 8 h after consuming BTJ and 5 h after BF (P < 0.05). Conclusions: These data reveal that BTJ and BF are rich in phytonutrients and may provide a useful means of increasing plasma NOx bioavailability. However, betanin, the major betalain in beetroot, showed poor bioavailability in plasma

Aerobic exercise intensity does not affect the anabolic signaling following resistance exercise in endurance athletes

Abstract: This study examined whether intensity of endurance stimulus within a concurrent training paradigm influenced the phosphorylation of signaling proteins associated with the mTOR and AMPK networks. Eight male cyclists completed (1) resistance exercise (RES), 6 × 8 squats at 80% 1-RM; (2) resistance exercise and moderate intensity cycling of 40 min at 65% V̇O2peak, (RES + MIC); (3) resistance exercise and high intensity interval cycling of 40 min with 6 alternating 3 min intervals of 85 and 45% V̇O2peak (RES + HIIC), in a cross-over design. Muscle biopsies were collected at rest and 3 h post-RES. There was a main effect of condition for mTORS2448 (p = 0.043), with a greater response in the RES + MIC relative to RES condition (p = 0.033). There was a main effect of condition for AMPKα2T172 (p = 0.041), with a greater response in RES + MIC, relative to both RES + HIIC (p = 0.026) and RES (p = 0.046). There were no other condition effects for the remaining protein kinases assessed (p > 0.05). These data do not support a molecular interference effect in cyclists under controlled conditions. There was no intensity-dependent regulation of AMPK, nor differential activation of anabolism with the manipulation of endurance exercise intensity.Peer reviewe

The plasma bioavailability of nitrate and betanin from Beta vulgaris rubra in humans

Purpose: To evaluate the plasma bioavailability of betanin and nitric oxide (NOx) after consuming beetroot juice (BTJ) and whole beetroot (BF). BTJ and BF were also analysed for antioxidant capacity, polyphenol content (TPC) and betalain content. Methods: Ten healthy males consumed either 250 ml of BTJ, 300 g of BF or a placebo drink, in a randomised, crossover design. Venous plasma samples were collected pre (baseline), 1, 2, 3, 5 and 8 h post-ingestion. Betanin content in BTJ, BF and plasma was analysed with reverse-phase high-performance liquid chromatography (HPLC) and mass spectrometry detection (LCMS). Antioxidant capacity was estimated using the Trolox equivalent antioxidant capacity (TEAC) and polyphenol content using Folin–Ciocalteu colorimetric methods [gallic acid equivalents (GAE)] and betalain content spectrophotometrically. Results: TEAC was 11.4 ± 0.2 mmol/L for BTJ and 3.4 ± 0.4 μmol/g for BF. Both BTJ and BF contained a number of polyphenols (1606.9 ± 151 mg/GAE/L and 1.67 ± 0.1 mg/GAE/g, respectively), betacyanins (68.2 ± 0.4 mg/betanin equivalents/L and 19.6 ± 0.6 mg/betanin equivalents/100 g, respectively) and betaxanthins (41.7 ± 0.7 mg/indicaxanthin equivalents/L and 7.5 ± 0.2 mg/indicaxanthin equivalents/100 g, respectively). Despite high betanin contents in both BTJ (~194 mg) and BF (~66 mg), betanin could not be detected in the plasma at any time point post-ingestion. Plasma NOx was elevated above baseline for 8 h after consuming BTJ and 5 h after BF (P < 0.05). Conclusions: These data reveal that BTJ and BF are rich in phytonutrients and may provide a useful means of increasing plasma NOx bioavailability. However, betanin, the major betalain in beetroot, showed poor bioavailability in plasma

The metabolic recovery of marathon runners: an untargeted 1H-NMR metabolomics perspective

Introduction: Extreme endurance events may result in numerous adverse metabolic, immunologic, and physiological perturbations that may diminish athletic performance and adversely affect the overall health status of an athlete, especially in the absence of sufficient recovery. A comprehensive understanding of the post-marathon recovering metabolome, may aid in the identification of new biomarkers associated with marathon-induced stress, recovery, and adaptation, which can facilitate the development of improved training and recovery programs and personalized monitoring of athletic health/recovery/performance. Nevertheless, an untargeted, multi-disciplinary elucidation of the complex underlying biochemical mechanisms involved in recovery after such an endurance event is yet to be demonstrated.Methods: This investigation employed an untargeted proton nuclear magnetic resonance metabolomics approach to characterize the post-marathon recovering metabolome by systematically comparing the pre-, immediately post, 24, and 48 h post-marathon serum metabolite profiles of 15 athletes.Results and Discussion: A total of 26 metabolites were identified to fluctuate significantly among post-marathon and recovery time points and were mainly attributed to the recovery of adenosine triphosphate, redox balance and glycogen stores, amino acid oxidation, changes to gut microbiota, and energy drink consumption during the post-marathon recovery phase. Additionally, metabolites associated with delayed-onset muscle soreness were observed; however, the mechanisms underlying this commonly reported phenomenon remain to be elucidated. Although complete metabolic recovery of the energy-producing pathways and fuel substrate stores was attained within the 48 h recovery period, several metabolites remained perturbed throughout the 48 h recovery period and/or fluctuated again following their initial recovery to pre-marathon-related levels