Innovative placement allocation model for pre-registration student nurses

Student nurses require a variety of high quality practice placements to prepare them for registration with the Nursing and Midwifery Council (NMC) yet in reality this can be difficult to achieve. This case study reports on the development and implementation of a Practice Placement Allocation Model that has provided one University in the north west of England and its partner practice placement healthcare organisations with a framework to shift from a traditional, process-led pre-registration nursing student placement allocation system (adult field) to a robust, proactive, student-focused approach. The model is based upon practice placement allocation partnership concepts and these include advanced planning of student placements and clear lines of communication between all stakeholders involved in the practice placement of students. Application of the model has resulted in the sharing of timely information across organisations via a central framework and this has allowed for any underlying practice allocation problems to be quickly identified and resolved. Importantly, each practice partner now fully understands the role that they play and how to communicate more effectively. Challenges and opportunities are presented together with the evidence of how the model can be transferred to other healthcare professions and fields of nursing. 5 key points: 1. The government is insistent on producing and maintain a nursing workforce that provides quality and compassionate nursing care 2. The nursing students’ practice placement is a key component of an effective pre-registration nurse education programme 3. Ensuring that all nursing students have the variety of placements can be a challenge to providers of pre-registration nurse education 4. Practice placements should be mapped and allocated according to the students education programme requirements and individual needs 5. Application of a Practice Placement Allocation Model provides the best platform for the effective placement of nursing students and promotes partnership working between stakeholder

LKB1 and AMPK and the cancer-metabolism link - ten years after

The identification of a complex containing the tumor suppressor LKB1 as the critical upstream kinase required for the activation of AMP-activated protein kinase (AMPK) by metabolic stress was reported in an article in Journal of Biology in 2003. This finding represented the first clear link between AMPK and cancer. Here we briefly discuss how this discovery came about, and describe some of the insights, especially into the role of AMPK in cancer, that have followed from it. In September 2003, our groups published a joint paper [1] in Journal of Biology (now BMC Biology) that identified the long-sought and elusive upstream kinase acting on AMP-activated protein kinase (AMPK) as a complex containing LKB1, a known tumor suppressor. Similar findings were reported at about the same time by David Carling and Marian Carlson [2] and by Reuben Shaw and Lew Cantley [3]; at the time of writing these three papers have received between them a total of over 2,000 citations. These findings provided a direct link between a protein kinase, AMPK, which at the time was mainly associated with regulation of metabolism, and another protein kinase, LKB1, which was known from genetic studies to be a tumor suppressor. While the idea that cancer is in part a metabolic disorder (first suggested by Warburg in the 1920s [4]) is well recognized today [5], this was not the case in 2003, and our paper perhaps contributed towards its renaissance. The aim of this short review is to recall how we made the original finding, and to discuss some of the directions that these findings have taken the field in the ensuing ten years

Substrate cycling between de novo lipogenesis and lipid oxidation: a thermogenic mechanism against skeletal muscle lipotoxicity and glucolipotoxicity

Life is a combustion, but how the major fuel substrates that sustain human life compete and interact with each other for combustion has been at the epicenter of research into the pathogenesis of insulin resistance ever since Randle proposed a 'glucose-fatty acid cycle' in 1963. Since then, several features of a mutual interaction that is characterized by both reciprocality and dependency between glucose and lipid metabolism have been unravelled, namely: 1. the inhibitory effects of elevated concentrations of fatty acids on glucose oxidation (via inactivation of mitochondrial pyruvate dehydrogenase or via desensitization of insulin-mediated glucose transport), 2. the inhibitory effects of elevated concentrations of glucose on fatty acid oxidation (via malonyl-CoA regulation of fatty acid entry into the mitochondria), and more recently 3. the stimulatory effects of elevated concentrations of glucose on de novo lipogenesis, that is, synthesis of lipids from glucose (via SREBP1c regulation of glycolytic and lipogenic enzymes). This paper first revisits the physiological significance of these mutual interactions between glucose and lipids in skeletal muscle pertaining to both blood glucose and intramyocellular lipid homeostasis. It then concentrates upon emerging evidence, from calorimetric studies investigating the direct effect of leptin on thermogenesis in intact skeletal muscle, of yet another feature of the mutual interaction between glucose and lipid oxidation: that of substrate cycling between de novo lipogenesis and lipid oxidation. It is proposed that this energy-dissipating substrate cycling that links glucose and lipid metabolism to thermogenesis could function as a 'fine-tuning' mechanism that regulates intramyocellular lipid homeostasis, and hence contributes to the protection of skeletal muscle against lipotoxicity

The Metabolic Consequences of Hepatic AMP-Kinase Phosphorylation in Rainbow Trout

AMP-activated protein kinase (AMPK), a phylogenetically conserved serine/threonine protein kinase, is proposed to function as a “fuel gauge” to monitor cellular energy status in response to nutritional environmental variations. However, in fish, few studies have addressed the metabolic consequences related to the activation of this kinase. This study demonstrates that the rainbow trout (Oncorhynchus mykiss) possesses paralogs of the three known AMPK subunits that co-diversified, that the AMPK protein is present in the liver and in isolated hepatocytes, and it does change in response to physiological (fasting-re-feeding cycle) and pharmacological (AICAR and metformin administration and incubations) manipulations. Moreover, the phosphorylation of AMPK results in the phosphorylation of acetyl-CoA carboxylase, a main downstream target of AMPK in mammals. Other findings include changes in hepatic glycogen levels and several molecular actors involved in hepatic glucose and lipid metabolism, including mRNA transcript levels for glucokinase, glucose-6-phosphatase and fatty acid synthase both in vivo and in vitro. The fact that most results presented in this study are consistent with the recognized role of AMPK as a master regulator of energy homeostasis in living organisms supports the idea that these functions are conserved in this piscine model

Colorful Niches of Phytoplankton Shaped by the Spatial Connectivity in a Large River Ecosystem: A Riverscape Perspective

Large rivers represent a significant component of inland waters and are considered sentinels and integrators of terrestrial and atmospheric processes. They represent hotspots for the transport and processing of organic and inorganic material from the surrounding landscape, which ultimately impacts the bio-optical properties and food webs of the rivers. In large rivers, hydraulic connectivity operates as a major forcing variable to structure the functioning of the riverscape, and–despite increasing interest in large-river studies–riverscape structural properties, such as the underwater spectral regime, and their impact on autotrophic ecological processes remain poorly studied. Here we used the St. Lawrence River to identify the mechanisms structuring the underwater spectral environment and their consequences on pico- and nanophytoplankton communities, which are good biological tracers of environmental changes. Our results, obtained from a 450 km sampling transect, demonstrate that tributaries exert a profound impact on the receiving river’s photosynthetic potential. This occurs mainly through injection of chromophoric dissolved organic matter (CDOM) and non-algal material (tripton). CDOM and tripton in the water column selectively absorbed wavelengths in a gradient from blue to red, and the resulting underwater light climate was in turn a strong driver of the phytoplankton community structure (prokaryote/eukaryote relative and absolute abundances) at scales of many kilometers from the tributary confluence. Our results conclusively demonstrate the proximal impact of watershed properties on underwater spectral composition in a highly dynamic river environment characterized by unique structuring properties such as high directional connectivity, numerous sources and forms of carbon, and a rapidly varying hydrodynamic regime. We surmise that the underwater spectral composition represents a key integrating and structural property of large, heterogeneous river ecosystems and a promising tool to study autotrophic functional properties. It confirms the usefulness of using the riverscape approach to study large-river ecosystems and initiate comparison along latitudinal gradients

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Optically stimulated luminescence dating as a geochronological tool for late quaternary sediments in the Red Sea region

This chapter concerns the use of luminescence methods as geochronological tools for dating Late Quaternary sediments in the Red Sea region. The dating methods all use stimulated luminescence to register signals developed in mineral systems in response to long term exposure to ionising radiation in the environment. The principles of luminescence dating are outlined followed by discussion of its application to the Arabian Peninsula, where, particularly in SE Arabia and parts of the interior, a growing corpus of work is emerging, which is helping to define past arid or humid periods of importance to palaeoclimatology and to archaeology. Turning to the Red Sea, studies conducted within the DISPERSE project are presented both in marine and terrestrial settings. The motivation for much of this work concerns definition of the environmental conditions and chronologies for hominin and human dispersion through Arabia. Data are presented which identify, for the first time, late Pleistocene evidence on the inner continental shelf near the Farasan Islands, using material from the 2013 cruise of RV AEGAEO . Results are also presented from the littoral fringe of southwest Saudi Arabia, identifying units associated with MIS5 which have palaeo-environmental and archaeological significance. It is to be hoped that further research in coming decades will continue to extend the regional chronology for the littoral fringe of the Red Sea. In this respect luminescence dating has potential to help define the environmental history of this important area, to assist with assigning marine and terrestrial features into unique stages of Quaternary climate cycles, and to promote better understanding of human-environment interactions in this dynamic area