'Ready to hit the ground running': alumni and employer accounts of a unique part-time distance learning pre-registration nurse education programme

Background This study explored the impact of The Open University’s (OU) pre-registration nursing programme on students’ employability, career progression and its contribution to developing the nursing workforce across the United Kingdom. Designed for healthcare support workers who are sponsored by their employers, the programme is the only part-time supported open/distance learning programme in the UK leading to registration as a nurse. The international literature reveals that relatively little is known about the impact of previous experience as a healthcare support worker on the experience of transition, employability skills and career progression. Objectives To identify alumni and employer views of the perceived impact of the programme on employability, career progression and workforce development. Design/Method A qualitative design using telephone interviews which were digitally recorded, transcribed verbatim prior to content analysis to identify recurrent themes. Settings Three geographical areas across the UK. Participants Alumni (n=17) and employers (n=7). Inclusion criterion for alumni was a minimum of two years post-qualifying experience. Inclusion criteria for employers were those that had responsibility for sponsoring students on the programme and employing them as newly qualified nurses. Results Four overarching themes were identified: Transition, Expectations, Learning for and in practice, and Flexibility. Conclusions Alumni and employers were of the view that the programme equipped them well to meet the competencies and expectations of being a newly qualified nurse. It provided employers with a flexible route to growing their own workforce and alumni the opportunity to achieve their ambition of becoming a qualified nurse when other more conventional routes would not have been open to them. Some of them had already demonstrated career progression. Generalising results requires caution due to the small, self-selecting sample but findings suggest that a widening participation model of pre-registration nurse education for employed healthcare support workers more than adequately prepares them for the realities of professional practice

A transcriptomic snapshot of early molecular communication between Pasteuria penetrans and Meloidogyne incognita

© The Author(s). 2018Background: Southern root-knot nematode Meloidogyne incognita (Kofoid and White, 1919), Chitwood, 1949 is a key pest of agricultural crops. Pasteuria penetrans is a hyperparasitic bacterium capable of suppressing the nematode reproduction, and represents a typical coevolved pathogen-hyperparasite system. Attachment of Pasteuria endospores to the cuticle of second-stage nematode juveniles is the first and pivotal step in the bacterial infection. RNA-Seq was used to understand the early transcriptional response of the root-knot nematode at 8 h post Pasteuria endospore attachment. Results: A total of 52,485 transcripts were assembled from the high quality (HQ) reads, out of which 582 transcripts were found differentially expressed in the Pasteuria endospore encumbered J2 s, of which 229 were up-regulated and 353 were down-regulated. Pasteuria infection caused a suppression of the protein synthesis machinery of the nematode. Several of the differentially expressed transcripts were putatively involved in nematode innate immunity, signaling, stress responses, endospore attachment process and post-attachment behavioral modification of the juveniles. The expression profiles of fifteen selected transcripts were validated to be true by the qRT PCR. RNAi based silencing of transcripts coding for fructose bisphosphate aldolase and glucosyl transferase caused a reduction in endospore attachment as compared to the controls, whereas, silencing of aspartic protease and ubiquitin coding transcripts resulted in higher incidence of endospore attachment on the nematode cuticle. Conclusions: Here we provide evidence of an early transcriptional response by the nematode upon infection by Pasteuria prior to root invasion. We found that adhesion of Pasteuria endospores to the cuticle induced a down-regulated protein response in the nematode. In addition, we show that fructose bisphosphate aldolase, glucosyl transferase, aspartic protease and ubiquitin coding transcripts are involved in modulating the endospore attachment on the nematode cuticle. Our results add new and significant information to the existing knowledge on early molecular interaction between M. incognita and P. penetrans.Peer reviewedFinal Published versio

FebriDx point-of-care test in patients with suspected COVID-19: a pooled diagnostic accuracy study

Background: Point-of-care (POC) tests for COVID-19 could relieve pressure on isolation resource, support infection prevention and control, and help commence more timely and appropriate treatment. We aimed to undertake a systematic review and pooled diagnostic test accuracy study of available individual patient data (IPD) to evaluate the diagnostic accuracy of a commercial POC test (FebriDx) in patients with suspected COVID-19.Methods: A literature search was performed on the 1st of October 2020 to identify studies reporting diagnostic accuracy statistics of the FebriDx POC test versus real time reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2. Studies were screened for risk of bias. IPD were sought from studies meeting the inclusion and exclusion criteria. Logistic regression was performed to investigate the study effect on the outcome of the RT-PCR test result in order to determine whether it was appropriate to pool results. Diagnostic accuracy statistics were calculated with 95% confidence intervals (CIs).Results: 15 studies were screened, and we included two published studies with 527 hospitalised patients. 523 patients had valid FebriDx results for Myxovirus resistance protein A (MxA), an antiviral host response protein. The FebriDx test produced a pooled sensitivity of 0.920 (95% CI: 0.875-0.950) and specificity of 0.862 (0.819-0.896) compared with RT-PCR, where there was an estimated true COVID-19 prevalence of 0.405 (0.364-0.448) and overall FebriDx test yield was 99.2%. Patients were tested at a median of 4 days [interquartile range: 2:9] after symptom onset. No differences were found in a sub-group analysis of time tested since the onset of symptoms.Conclusions: Based on a large sample of patients from two studies during the first wave of the SARS-CoV-2 pandemic, the FebriDx POC test had reasonable diagnostic accuracy in a hospital setting with high COVID-19 prevalence, out of influenza season. More research is required to determine how FebriDx would perform in other healthcare settings with higher or lower COVID-19 prevalence, different patient populations, or when other respiratory infections are in circulation

Goal formulation and tracking in child mental health settings: when is it more likely and is it associated with satisfaction with care?

Goal formulation and tracking may support preference-based care. Little is known about the likelihood of goal formulation and tracking and associations with care satisfaction. Logistic and Poisson stepwise regressions were performed on clinical data for N = 3757 children from 32 services in the UK (M age = 11; SDage = 3.75; most common clinician-reported presenting problem was emotional problems = 55.6%). Regarding the likelihood of goal formulation, it was more likely for pre-schoolers, those with learning difficulties or those with both hyperactivity disorder and conduct disorder. Regarding the association between goal formulation and tracking and satisfaction with care, parents of children with goals information were more likely to report complete satisfaction by scoring at the maximum of the scale. Findings of the present research suggest that goal formulation and tracking may be an important part of patient satisfaction with care. Clinicians should be encouraged to consider goal formulation and tracking when it is clinically meaningful as a means of promoting collaborative practice

The Outsourced Chief Investment Officer Model of Management and the Principal–Agent Problem

By convention, the responsibility for framing pension fund investment strategy lies with boards and their investment subcommittees, outsourcing the major part of the implementation of chosen investment strategies to various asset managers. In recent years, some pension funds have begun to outsource both investment strategy and implementation, thereby locating authority and responsibility with external providers. In this article, we focus on the Outsourced Chief Investment Officer (OCIO) model of management, emphasizing the forces driving the adoption of this type of arrangement, its characteristics, and what defines success. This model of management has the merit of replacing multiple providers with one contract on a fee-for-performance basis. For this model to be effective, it is shown that it must be well governed. This requires clarity of mandate and delegation, as has been noted in prior research on pension fund governance. In addition, any governance regime must address the principal–agent problem if the OCIO model is to realize clients’ ambitions. This may require high-level board competence, investment advisory services, and performance assessment processes that are sensitive to the unseen forces that influence success

The Outsourced Chief Investment Officer Model of Management and the Principal–Agent Problem

By convention, the responsibility for framing pension fund investment strategy lies with boards and their investment subcommittees, outsourcing the major part of the implementation of chosen investment strategies to various asset managers. In recent years, some pension funds have begun to outsource both investment strategy and implementation, thereby locating authority and responsibility with external providers. In this article, we focus on the Outsourced Chief Investment Officer (OCIO) model of management, emphasizing the forces driving the adoption of this type of arrangement, its characteristics, and what defines success. This model of management has the merit of replacing multiple providers with one contract on a fee-for-performance basis. For this model to be effective, it is shown that it must be well governed. This requires clarity of mandate and delegation, as has been noted in prior research on pension fund governance. In addition, any governance regime must address the principal–agent problem if the OCIO model is to realize clients’ ambitions. This may require high-level board competence, investment advisory services, and performance assessment processes that are sensitive to the unseen forces that influence success

Innovative models of pension fund governance in the context of the global financial crisis.

The global financial crisis has posed profound threats to pension welfare worldwide. This is particularly so in the United Kingdom with the closure of private defined benefit plans, and the heavy losses experienced by many defined contribution pension plan participants. Meeting these challenges has placed a premium on plan governance, given its link to fund performance. This paper begins by considering the academic literature on institutional change, including an analysis of the most common ways of responding to a changing environment. It is noted that the nature and scope of institutional response to a changing environment depends, in part, upon funds’ governance budgets, including time, expertise and common commitment. Our research on UK governance suggests that incremental adaptation has been the operative strategy augmented, in some cases, by the adoption of UK corporate governance practices. Three types of innovation in the governance of UK pension plans are identified: the transformation of decision-making, the pension buy-out and fiduciary management alongwith an emerging ‘new’ model of pension fund governance. In the penultimate section of this paper, lessons from UK best practice are drawn for institutions that face unprecedented challenges in realising the pension promise. Thereafter, we suggest a possible approach for regulators to strengthen the pension fund sector, based on improved disclosure, independent board chairs and the skills of board members