Intracellular survival and saprophytic growth of isolates from the Burkholderia cepacia complex in free-living amoebae

Members of the taxonomically diverse Burkholderia cepacia complex have become a major health risk for patients with cystic fibrosis (CF). Although patient-to-patient transmission of B. cepacia strains has been well-documented, very little is known about possible vehicles of transmission and reservoirs for these micro-organisms. In this work, it is shown that strains of the B. cepacia complex can survive within different isolates of the genus Acanthamoeba. Trophozoites containing bacteria developed profuse cytoplasmic vacuolization. Vacuolization was not detected in trophozoites infected with live Escherichia coli or heat-killed B. cepacia, or by incubation of trophozoites with filter-sterilized culture supernatants, indicating that metabolically active intracellular bacteria are required for the formation of vacuoles. Experiments with two different B. cepacia strains and two different Acanthamoeba isolates revealed that bacteria display a low level of intracellular replication approximately 72-96 h following infection. In contrast, extracellular bacteria multiplied efficiently on by-products released by amoebae. The findings suggest that amoebae may be a reservoir for B. cepacia and possibly a vehicle for transmission of this opportunistic pathogen among CF patients.

Hydrogel-Forming Microneedle Arrays for Enhanced Transdermal Drug Delivery

Unique microneedle arrays prepared from crosslinked polymers, which contain no drug themselves, are described. They rapidly take up skin interstitial fluid upon skin insertion to form continuous, unblockable, hydrogel conduits from attached patch-type drug reservoirs to the dermal microcirculation. Importantly, such microneedles, which can be fabricated in a wide range of patch sizes and microneedle geometries, can be easily sterilized, resist hole closure while in place, and are removed completely intact from the skin. Delivery of macromolecules is no longer limited to what can be loaded into the microneedles themselves and transdermal drug delivery is now controlled by the crosslink density of the hydrogel system rather than the stratum corneum, while electrically modulated delivery is also a unique feature. This technology has the potential to overcome the limitations of conventional microneedle designs and greatly increase the range of the type of drug that is deliverable transdermally, with ensuing benefits for industry, healthcare providers and, ultimately, patients.

How standardised patients award global scores in OSCEs: a qualitative study

Standardized patients (SPs) are often asked to award global scores on the humanistic aspects of a candidate’s performance in an OSCE. However, little is known about the process by which SPs arrive at their mark.
Five focus groups of SPs, using a convenience sample, were used to collect data until saturation. Thematic analysis was carried out independently by three researchers using a grounded theory approach.

Four major themes contributed to their decision-making process: environment, relationships within the exam, preparedness for the task and expectations of the student’s performance. Environmental factors included the station itself, the rating scale and examiner fatigue. Relationship factors included first impressions, the sense of purpose derived from examining and a tendency to mirror the examiner’s reaction. Factors relating to preparedness for task involved experience as an SP and technical aspects, such as the need for calibration. Lastly, expectations of performance were related to preconceptions about what makes a ‘good’ student, including their level of studies, appearance and technical performance.

In assessing students, SPs drew on their wider attitudes and experiences. SPs did not limit their assessment to humanistic traits but often included technical performance. Thus, SPs to some extent assessed a similar construct to examiners and this may help to explain the increased reliability associated with using SP scores. SP global scores are a useful adjunct but the process by which SPs award marks is complex and provides a challenge for training and standardisation.

Organization specific predictors of job satisfaction: findings from a Canadian multi-site quality of work life cross-sectional survey

Background: Organizational features can affect how staff view their quality of work life. Determining staff perceptions about quality of work life is an important consideration for employers interested in improving employee job satisfaction. The purpose of this study was to identify organization specific predictors of job satisfaction within a health care system that consisted of six independent health care organizations.

Methods: 5,486 full, part and causal time (non-physician) staff on active payroll within six organizations (2 community hospitals, 1 community hospital/long-term care facility, 1 long-term care facility, 1 tertiary care/community health centre, and 1 visiting nursing agency) located in five communities in Central West Ontario, Canada were asked to complete a 65-item quality of work life survey. The self-administered questionnaires collected staff perceptions of: co-worker and supervisor support; teamwork and communication; job demands and decision authority; organization characteristics; patient/resident care; compensation and benefits; staff training and development; and impressions of the organization. Socio-demographic data were also collected.

Results: Depending on the organization, between 15 and 30 (of the 40 potential predictor) variables were found to be statistically associated with job satisfaction (univariate analyses). Logistic regression analyses identified the best predictors of job satisfaction and these are presented for each of the six organizations and for all organizations combined.

Conclusions: The findings indicate that job satisfaction is a multidimensional construct and although there appear to be some commonalities across organizations, some predictors of job satisfaction appear to be organization and context specific.

'O daughter ... forget your people and your father's house': Early Modern Women Writers and the Spanish Imaginary

‘O daughter … forget your people and your father’s house’: Early Modern Women Writers and the Spanish ImaginaryAnne Holloway and Ramona WrayHolloway and Wray consider the perspectives offered by two very different seventeenth-century women (Mary Bonaventure Browne, or Mother Browne (b.1615- and Lady Ann Fanshawe (b.1625) both of whom exchanged Ireland for Spain, and both of whom record journeys both ‘real’ and imagined in their writings. Browne’s deployment of hagiographical tropes in her History of the Poor Clares may reveal the potential impact of Iberian conventual culture; her allusions to the markers of sanctity insistent on the immutability of the body, whilst accepting and anticipating spectral presence in the form of bilocation. Fanshawe’s Memoirs are considered alongside the material legacy of her ‘Booke of Receipts of Physickes, Salues, Waters, Cordialls, Preserues and Cookery.’ Her impressions both in transit and within the domus are similarly marked by receptivity and sensitivity to the host culture. Amidst a backdrop of religious persecution and political uncertainty, in both cases Spain emerges as a potentially enabling context for creativity and self-expression.Keywords: Memoir; Franciscan; Poor Clares; Fanshawe; Mary Bonaventure Browne; hagiography; life-writing; autobiography, women writers

‘“Indelible characters”:Tattoos, Power and the Late Nineteenth-Century Irish Convict Body

Since the late nineteenth-century works of criminologists Lombroso and Lacassagne, tattoos in Europe have been commonly associated with deviant bodies. Like many other studies of tattoos of non-indigenous origin, the locus of our research is the convict body. Given the corporeal emphasis of prison records, we argue that tattoos form a crucial part of the power dynamic. Tattoos in the carceral context embody an inherent paradox of their being a component in the reidentification of 'habitual criminals'. We argue that their presence can be regarded as an expression of convict agency: by the act of imprinting unique identifiers on their bodies, convicts boldly defied the official gaze, while equally their description in official records exacted power over the deviant body. Cursory findings show an alignment with other national studies; corporeal inscriptions in Ireland were more prevalent in men's prisons than women's and associated, however loosely, with certain occupations. For instance, maritime and military motifs find representation. Recidivists were more likely to have tattoos than first-time offenders; inscriptions were described as monotone, rudimentary in design and incorporated a limited range of impressions. Further to our argument that tattoos form an expression of convict defiance of prison authority, we have found an unusual idiosyncrasy in the convict record, that is, that the agency of photography, while undermined in general terms, was manipulated by prison officers.

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

This paper presents the benefits of an innovative education partnership between lecturers from the School of Nursing and Midwifery, Queens University Belfast and Arts Care, a unique Arts and Health Charity in Northern Ireland, to engage nursing students in life sciences

Nursing and Midwifery students often struggle to engage with life science modules because they lack confidence in their ability to study science.This project was funded by a Teaching Innovation Award from the School of Nursing and Midwifery, Queens University Belfast, to explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. The project was facilitated through collaboration between Teaching staff from the School of Nursing and Midwifery and Arts Care, Northern Ireland. This unique Arts and Health Charity believes in the benefits of creativity to well being.

RESEARCH OBJECTIVE(S)
To explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology.

METHODS AND METHODLOGY
Students participated in a series of workshops designed to explore the cells, tissues and organs of the human body through the medium of felt. Facilitated by an Arts Care artist, and following self-directed preparation, students discussed and translated their learning of the cells, tissues and organs of the human body into striking felt images. During the project students kept a reflective journal of their experience to document how participation in the project enhanced their learning and professional development

RESULTS
Creativity transformed and brought to life the students learning of the cells, tissues and organs of the human body.

The project culminated in the exhibition of a unique body of artwork which has been exhibited across Northern Ireland in hospitals and galleries and viewed by fellow students, teaching staff, nurses from practice, artists, friends, family and members of the public.

CONCLUSION
The impact of creativity learning strategies in nurse education should be further explored.

REFERENCES
Bennett, M and Rogers, K.MA. (2014) First impressions matter: an active, innovative and engaging method to recruit student volunteers for a pedagogic project. Reflections, Available online at: QUB, Centre for Educational Development / Publications / Reflections Newsletter, Issue 18, June 2014.

Chickering,A.W. and Gamson,Z.F. (1987) Seven principles for good practice in undergraduate education The American Association for Higher Education Bulletin, March. http://www.aahea.org/aahea/articles/sevenprinciples1987.htm, accessed 8th August 2014

Fell, P., Borland, G., Lynne, V. (2012) Lab versus lectures: can lab based practical sessions improve nursing students’ learning of bioscience? Health and Social Care Education 3:1, 33-38

Tacrolimus is not associated with gingival overgrowth in renal transplant patients

BACKGROUND: Cyclosporin A is used extensively to prevent the rejection of allogenic renal transplants. However, it is associated with a variety of undesirable side effects including gingival overgrowth. Tacrolimus (FK506), has been marketed as an effective alternative immunosuppressant to cyclosporin A and recent subjective reports suggest patients taking it complain infrequently of gingival problems. This clinical investigation was undertaken to confirm whether or not tacrolimus adversely affected the gingival health of renal transplant recipients.

METHODS: Renal transplant patients (RTPs) under the care of the Renal Transplantation Service at the Manchester Royal Infirmary, who had received a renal allograft at least 18 months earlier, were recruited for this study. All but one of the RTPs had been taking tacrolimus since transplantation. The other had commenced tacrolimus therapy two months after receiving her allograft. A hospital based control group was recruited from non transplanted individuals attending the Turner Dental School, Manchester. Each patient underwent a detailed dental assessment and had dental impressions taken. The extent of gingival overgrowth was determined from plaster models.

RESULTS: 25 renal transplant recipients and 26 control patients were included in the study. None of the individuals in either the tacrolimus or control groups had clinically significant overgrowth. The patients in the tacrolimus group with the highest overgrowth scores were those also taking calcium antagonists as treatment for hypertension.

CONCLUSION: This study demonstrates that tacrolimus has no adverse effects on the gingival tissues and thus has potential as an alternative immunosuppressant for individuals susceptible to developing cyclosporin A-induced gingival overgrowth.

The Un-Politics of New Public Management in Ireland

Many of the principles and indeed the rhetoric of New Public Management proved attractive to both politicians and senior bureaucrats across the developed world as a remedy for problems in policy processes. Ireland shares many features of its constitutional structures and political practices with Britain, Canada, Australia, New Zealand, all of them early and enthusiastic adopters of NPM. Some of the organizational and procedural changes in Irish public administration do indeed bear similarities to those we would expect to see as a result of adopting principles of NPM. However, we contend that surface impressions are misleading. Drawing on a time-series database of Irish state institutions, we show that organizational changes were not necessarily driven by NPM. The absence of strong political drivers meant that reform initiatives did not fundamentally alter the configuration of the Irish public administration. Many of the problems that NPM was intended to address are only now coming under scrutiny.