'20 days protected learning' - students' experiences of an Overseas Nurses Programme - 4 years on: A retrospective survey

Background From September 2005 the Nursing and Midwifery Council (NMC) introduced new arrangements for the registration of non-EU overseas nurses which requires all applicants to undertake '20 days of protected learning' time in the UK and for some, a period of supervised practice. A survey was undertaken at Bournemouth University, which offers a '20 days protected learning only' programme, to elicit overseas nurses' demographic details, experiences in completing the programme and their 'final destinations' once registered. Methods An online survey was devised which contained a mixture of tick box and open ended questions which covered demographic details, views on the programme and final destinations This was uploaded to www.SurveyMonkey.com and sent out to nurses who had completed the Overseas Nurses Programme (ONP) with Bournemouth University (n=1050). Quantiative data were analysed using descriptive statistics and the qualitative data were coded and analysed using content analysis . Results There were 251 respondents (27.7% response rate). The typical 'profile' of a nurse who responded to the survey was female, aged 25-40 years and had been qualified for more than 5 years with a bachelors degree. The majority came from Australia on a 2 year working holiday visa and the key final destination in the UK, on registration with the NMC, was working for an agency. There were five key findings regarding experience of the programe. Of those surveyed 61.2% did not feel it necessary to undergo an ONP; 71.6% felt that they should be able to complete the programme on-line in their own country; 64.2% that the ONP should only contain information about delivery of healthcare in UK and Legal and professional (NMC) issues; 57% that European nurses should also undergo the same programme and sit an IELTS test; and 68.2% that the programme was too theory orientated; and should have links to practice (21%). Conclusions The NMC set the admissions criteria for entry to the register and Standards for an ONP. The findings of this survey raise issues regarding the percieved value and use of this approach for overseas nurses, and it may be helpful to take this into account when considering future policy

No evidence for ape plasmodium infections in humans in Gabon

African great apes are naturally infected by a multitude of Plasmodium species most of them recently discovered, among which several are closely related to human malaria agents. However, it is still unknown whether these animals can serve as source of infections for humans living in their vicinity. To evaluate this possibility, we analysed the nature of Plasmodium infections from a bank of 4281 human blood samples collected in 210 villages of Gabon, Central Africa. Among them, 2255 were detected positive to Plasmodium using molecular methods (Plasmodium Cytochrome b amplification). A high throughput sequencing technology (454 GS-FLX Titanium technology, Roche) was then used to identify the Plasmodium species present within each positive sample. Overall, we identified with confidence only three species infecting humans in Gabon: P. falciparum, P. malariae and P. ovale. None of the species known to infect non-human primates in Central Africa was found. Our study shows that ape Plasmodium parasites of the subgenus Laverania do not constitute a frequent source of infection for humans. It also suggests that some strong host genetic barriers must exist to prevent the cross species transmission of ape Plasmodium in a context of ever increasing contacts between humans and wildlife

A. Schematic phylogenetic representation of relationships among <i>Plasmodium</i> species circulating in Central Africa; B. Location, in Gabon, of the 210 villages (red circles) where human blood samples were collected between 2005 and 2008.

<p>Distribution of the different sub-species of chimpanzees, bonobos and of gorillas in Central Africa is shown.</p

Schematic representation of the <i>Plasmodium falciparum</i> mitochondrial genome.

<p>In green are represented the three protein coding genes of the mitochondrial genome of <i>Plasmodium</i> parasites. On the <i>Cytochrome b</i> gene, used for <i>Plasmodium</i> diagnostic in this study, the position of the two SNVs (single nucleotide variations) allowing to distinguish <i>P</i>. <i>falciparum</i> from the ape <i>Laveranias</i> is shown in orange.</p

Proportion of individuals harbouring at least one read assigned to one <i>Plasmodium</i> reference species (listed in S3 Table).

<p>Proportion of individuals harbouring at least one read assigned to one <i>Plasmodium</i> reference species (listed in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0126933#pone.0126933.s003" target="_blank">S3 Table</a>).</p

Relationship between (i) the total number of reads sequenced in the “<i>P</i>. <i>vivax</i> and ape <i>Plasmodium</i>” positive controls and (ii) the total number of reads assigned to <i>P</i>. <i>vivax</i> or an ape <i>Plasmodium</i> species in the human samples.

<p>Relationship between (i) the total number of reads sequenced in the “<i>P</i>. <i>vivax</i> and ape <i>Plasmodium</i>” positive controls and (ii) the total number of reads assigned to <i>P</i>. <i>vivax</i> or an ape <i>Plasmodium</i> species in the human samples.</p

Relationship between (i) the Levenshtein distance computed between the tags of the positive controls and those of the human samples and (ii) the proportion of individuals harbouring “Unexpected Reads”.

<p>Relationship between (i) the Levenshtein distance computed between the tags of the positive controls and those of the human samples and (ii) the proportion of individuals harbouring “Unexpected Reads”.</p

Cross-contamination estimates from the positive controls in our experimental design.

<p>A. Comparison of the proportion of individuals displaying “Unexpected Reads” (URs) (i.e reads not assigned to <i>P</i>. <i>falciparum</i>, <i>P</i>. <i>malariae</i> or <i>P</i>. <i>ovale</i>) between PCR plates where positive individuals were amplified (PCR plates with positive controls) and those without positive controls (PCR plates without positive controls). B. Comparison of the average number of “Unexpected Reads” (URs) per individual in PCR plates with (PCR plates with positive controls) and without the positive controls (PCR plates without positive controls).</p

Comparison of the total number of <i>P</i>. <i>falciparum</i> reads observed in individuals displaying (i) no <i>P</i>. <i>praefalciparum</i> or (ii) more than one.

<p>Comparison of the total number of <i>P</i>. <i>falciparum</i> reads observed in individuals displaying (i) no <i>P</i>. <i>praefalciparum</i> or (ii) more than one.</p