Developing an integrated approach to the assessment of student nurse competence using the Total Client Care (TCC) assessment tool

The aim of this study was to evaluate the validity and reliability of an integrated assessment of competence using the Total Client Care (TCC) assessment tool within an undergraduate Nursing course. The Total Client Care Assessment Tool aims to assess multiple competencies in an integrated way thereby mirroring the way in which registered nurses are expected to practice. TCC is a tool designed to assess the student's ability to provide holistic care to a client over a specified period of time. TCC measures the student's performance around four constructs, these are: Communication, Planning and Responding, Care Delivery and Assessing and Evaluating. G-theory analysis revealed satisfactory levels of global reliability on single use G co-efficient 0.90 although this dropped to 0.76 when used on eight occasions to assess the same students over a two-year period. Analysis of variance revealed that students and assessment occasions accounted for most of the variance. The TCC assessment tool is useful as it provides data about the student's performance when providing actual care. When used as part of a wider system of assessment involving triangulation of evidence from a number of sources the tool can support mentor judgements about the achievement of competence

COVID-19 vaccines and vaccine administration

This article provides an overview of current COVID-19 vaccines available within the UK, including their mode of action, storage and handling. It outlines the recommendations on priority groups for vaccination and provides insight into the training recommendations for vaccinators

Development and Evaluation of the Validity and Reliability of the Leading and Managing Care Pre-Registration Nursing Student Assessment Tool

Background: Clinical nursing leadership influences patient safety and the quality of care provided. Nurses at all levels require leadership and management skills. Despite recognition of the importance of leadership, student nurses often feel ill prepared to make the transition to Registered Nurse and struggle with prioritisation and delegation. In order to standardise student experience and promote the development of skills and attributes, a leadership and management competency assessment was developed and implemented. Aims: This study aimed to identify the constructs that should be part of an assessment of student nurse competence in relation to clinical nursing leadership, and to evaluate the tool’s reliability. Method: The first phase was to construct the competency assessment tool, using a mixture of deductive methods, including literature and expert review. Second, psychometric evaluation of the tool, including tests to examine its internal consistency and reliability, comparing test and retest reliability, exploratory factor analysis and generalisability theory analysis to identify reliability and sources of error. Results: Five attributes were identified for inclusion in the tool alongside a scale of competence. 150 assessments were conducted with an average time between each assessment of three days. The results show that the tool was consistent over time with no significant difference in the mean scores. The Cronbach alpha was 0.84 and the tool had good internal consistency. The results of the factor analysis revealed loading onto a single construct. Generalisability theory analysis revealed 0.90 global reliability, with students accounting for the majority of the variation in scores. Conclusions: The Leading and Managing Care assessment tool represents a valid and reliable assessment of student nurse competence to lead care delivery. Use of the tool during practice placement allows for a structured approach to the development of skills around prioritisation, management of resources, communication and the management of risk

Mental Health Beyond Austerity: A ‘Mental Wealth’ Approach to post-austerity policy-making

The proposals in this document arose out of preparatory work by the four authors for the TUC ‘Closing the Gap’ conference in Salford as well as contributions by participants at the event. The manifesto in Appendix I represents some very preliminary ideas and suggestions towards a mental w/health manifesto, but does not claim to be a comprehensive statement nor represent the position of any particular organization or campaign. However, if there is a wish amongst wider mental w/health campaigns to do so, the authors are open to further discussions to develop this in democratic, collaborative and inclusive ways into a post-austerity Mental Health/Wealth Manifesto to inform ongoing activism

An Integrative Review Exploring Psycho-Social Impacts and Therapeutic Interventions for Parent Caregivers of Young People Living with Duchenne’s Muscular Dystrophy

The purpose of this integrative review was to explore psycho-social impacts and therapeutic interventions for parent caregivers of young people living with Duchenne’s Muscular Dystrophy (DMD). Electronic databases were searched for research publications between 2010 and 2020. This included Medline, CINAHL, PsycINFO, ERIC, ERC, and AMED. Four central themes emerged: Living with DMD; Knowing and telling; Transitioning; and Building resilience. The impact on parents caring for a child with DMD affected all aspects of their lives, changed over time, and had identifiable peak stress points. Unmet parental information and support needs left parents struggling in their role. Transition required changes to parenting behaviors and required adaptation and resilience. It is proposed that future investment should focus on anticipating family need, targeting intervention cognizant of predictable stress points and building resilience through social community. Parents may then be better positioned to support their child in looking forward

Mental Well-Being in UK Higher Education During Covid-19: Do Students Trust Universities and the Government?

This paper draws upon the concept of recreancy to examine the mental well-being of university students during the Covid-19 pandemic. Briefly, recreancy is loss of societal trust that results when institutional actors can no longer be counted on to perform their responsibilities. Our study of mental well-being and recreancy focuses on the role of universities and government regulators within the education sector. We surveyed 600 UK students attending 161 different public higher education providers in October 2020 during a time when many UK students were isolated in their residences and engaged in online learning. We assessed student well-being using the Short Warwick-Edinburgh Mental Well-being Scale (scored 7–35) and found the mean score to be 19.9 [95% confidence interval (CI) 19.6, 20.2]. This level of well-being indicates that a significant proportion of UK students face low levels of mental well-being. Structural equation modeling (SEM) analysis indicates that high recreancy—measured as a low trust in universities and the government—is associated with low levels of mental well-being across the student sample. While these findings are suggestive, they are also important and we suggest that government and university leaders should not only work to increase food and housing security during the Covid-19 pandemic, but also consider how to combat various sector trends that might intensify recreancy

Variants associated withHHIP expression have sex-differential effects on lung function

Publisher Copyright: © 2020 Fawcett KA et al.Background: Lung function is highly heritable and differs between the sexes throughout life. However, little is known about sex-differential genetic effects on lung function. We aimed to conduct the first genome-wide genotype-by-sex interaction study on lung function to identify genetic effects that differ between males and females. Methods: We tested for interactions between 7,745,864 variants and sex on spirometry-based measures of lung function in UK Biobank (N=303,612), and sought replication in 75,696 independent individuals from the SpiroMeta consortium. Results: Five independent single-nucleotide polymorphisms (SNPs) showed genome-wide significant (P<5x10 -8) interactions with sex on lung function, and 21 showed suggestive interactions (P<1x10 -6). The strongest signal, from rs7697189 (chr4:145436894) on forced expiratory volume in 1 second (FEV 1) (P=3.15x10 -15), was replicated (P=0.016) in SpiroMeta. The C allele increased FEV 1 more in males (untransformed FEV 1 β=0.028 [SE 0.0022] litres) than females (β=0.009 [SE 0.0014] litres), and this effect was not accounted for by differential effects on height, smoking or pubertal age. rs7697189 resides upstream of the hedgehog-interacting protein ( HHIP) gene and was previously associated with lung function and HHIP lung expression. We found HHIP expression was significantly different between the sexes (P=6.90x10 -6), but we could not detect sex differential effects of rs7697189 on expression. Conclusions: We identified a novel genotype-by-sex interaction at a putative enhancer region upstream of the HHIP gene. Establishing the mechanism by which HHIP SNPs have different effects on lung function in males and females will be important for our understanding of lung health and diseases in both sexes.Peer reviewe

Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk

The timing of puberty is a highly polygenic childhood trait that is epidemiologically associated with various adult diseases. Using 1000 Genomes Project-imputed genotype data in up to similar to 370,000 women, we identify 389 independent signals (P <5 x 10(-8)) for age at menarche, a milestone in female pubertal development. In Icelandic data, these signals explain similar to 7.4% of the population variance in age at menarche, corresponding to similar to 25% of the estimated heritability. We implicate similar to 250 genes via coding variation or associated expression, demonstrating significant enrichment in neural tissues. Rare variants near the imprinted genes MKRN3 and DLK1 were identified, exhibiting large effects when paternally inherited. Mendelian randomization analyses suggest causal inverse associations, independent of body mass index (BMI), between puberty timing and risks for breast and endometrial cancers in women and prostate cancer in men. In aggregate, our findings highlight the complexity of the genetic regulation of puberty timing and support causal links with cancer susceptibility

Variants associated with HHIP expression have sexdifferential effects on lung function

Background: Lung function is highly heritable and differs between the sexes throughout life. However, little is known about sex-differential genetic effects on lung function. We aimed to conduct the first genome-wide genotype-by-sex interaction study on lung function to identify genetic effects that differ between males and females.Methods: We tested for interactions between 7,745,864 variants and sex on spirometry-based measures of lung function in UK Biobank (N=303,612), and sought replication in 75,696 independent individuals from the SpiroMeta consortium.Results: Five independent single-nucleotide polymorphisms (SNPs) showed genome-wide significant (P-8) interactions with sex on lung function, and 21 showed suggestive interactions (P-6). The strongest signal, from rs7697189 (chr4:145436894) on forced expiratory volume in 1 second (FEV1) (P=3.15x10-15), was replicated (P=0.016) in SpiroMeta. The C allele increased FEV1 more in males (untransformed FEV1 β=0.028 [SE 0.0022] litres) than females (β=0.009 [SE 0.0014] litres), and this effect was not accounted for by differential effects on height, smoking or pubertal age. rs7697189 resides upstream of the hedgehog-interacting protein (HHIP) gene and was previously associated with lung function and HHIP lung expression. We found HHIP expression was significantly different between the sexes (P=6.90x10-6), but we could not detect sex differential effects of rs7697189 on expression.Conclusions: We identified a novel genotype-by-sex interaction at a putative enhancer region upstream of the HHIP gene. Establishing the mechanism by which HHIP SNPs have different effects on lung function in males and females will be important for our understanding of lung health and diseases in both sexes.</p