Evaluation of QuantiFERON SARS-CoV-2 interferon-γ release assay following SARS-CoV-2 infection and vaccination.

T cells are important in preventing severe disease from SARS-CoV-2, but scalable and field-adaptable alternatives to expert T-cell assays are needed. The interferon-gamma release assay QuantiFERON platform was developed to detect T-cell responses to SARS-CoV-2 from whole blood with relatively basic equipment and flexibility of processing timelines. Forty-eight participants with different infection and vaccination backgrounds were recruited. Whole blood samples were analysed using the QuantiFERON SARS-CoV-2 assay in parallel with the well-established 'Protective Immunity from T Cells in Healthcare workers' (PITCH) ELISpot, which can evaluate spike-specific T-cell responses. The primary aims of this cross-sectional observational cohort study were to establish if the QuantiFERON SARS-Co-V-2 assay could discern differences between specified groups and to assess the sensitivity of the assay compared with the PITCH ELISpot. The QuantiFERON SARS-CoV-2 distinguished acutely infected individuals (12-21 days post positive PCR) from naïve individuals (P < 0.0001) with 100% sensitivity and specificity for SARS-CoV-2 T cells, whilst the PITCH ELISpot had reduced sensitivity (62.5%) for the acute infection group. Sensitivity with QuantiFERON for previous infection was 12.5% (172-444 days post positive test) and was inferior to the PITCH ELISpot (75%). Although the QuantiFERON assay could discern differences between unvaccinated and vaccinated individuals (55-166 days since second vaccination), the latter also had reduced sensitivity (44.4%) compared to the PITCH ELISpot (66.6%). The QuantiFERON SARS-CoV-2 assay showed potential as a T- cell evaluation tool soon after SARS-CoV-2 infection but has lower sensitivity for use in reliable evaluation of vaccination or more distant infection.

Delivering Covid-19 research during the UK pandemic: Experiences of a local research taskforce.

AIM: During the COVID-19 pandemic in the UK, clinical research nurses had to work in new ways and under significant pressure to generate evidence for the developing health crisis. Research nurse support needs, personal and professional challenges have not been explored. This study addresses that gap, generating learning for continued support and development of the research nurse specialty and its ability to respond to public health priorities. DESIGN: We employed a qualitative exploratory approach through online open-ended interviews to explore research nurses' experiences of delivering research during the pandemic using principles of Grounded Theory. METHODS: Fifteen research nurses in the local research taskforce were identified through purposive sampling. Qualitative interviews were conducted online between November 2020 and January 2021 and analysed using the principles of constructivist grounded theory. RESULTS: Three themes of adapting to uncertainty, inclusive leadership and finding validity in the stretch zone were generated in the analysis. CONCLUSION: A model of inclusive leadership and support can facilitate high-functioning performance in a research team, supporting a rapid, confident and efficient response to research needs. IMPACT: Research nurses, a previously invisible workforce, have proved critical to the pandemic response. This study explores the experiences of a team of redeployed research nurses and develops a theory of their experience as they were undertaking the rapid delivery of urgent public health studies during COVID-19. What was found was a process of adaptation and resilience through collaborative teamwork, a strong sense of purpose and role validation enabled by an inclusive leadership style. This work will drive future development of a model of research nursing with a focus on collaboration between research and clinical colleagues.

Older people's experiences of falling and perceived risk of falls in the community: A narrative synthesis of qualitative research.

AIM: To examine qualitative research exploring older people's experiences of falling and the perceived risk of falling in the community. This will contribute new insights into how falling is perceived by the older community. BACKGROUND: Falls are a major problem for older people and healthcare services across the world. Accidental falls in the community are a persistent problem that is generally recognised as an intrinsic risk of ageing. This review provides a new synthesis of evidence that considers older people's perception of falls in the community as new insights are needed if the increasing problems of falls are to be addressed. DESIGN: Synthesis of the qualitative literature employing Noblit and Hare's method of reciprocal translation. CINAHL, Medline, EMBASE, PsychINFO and BNI were searched 1999-2015. METHODS: Noblit and Hare's method of reciprocal translations was used to conceive this meta-ethnographic synthesis. The ENTREQ statement was employed as a tool for reporting the synthesis of qualitative research. The PRISMA statement was used for reporting the different phase of the literature search, and the Critical Appraisal Skills Programme qualitative research checklist was used as an appraisal framework. RESULTS: Eleven papers fit the inclusion criteria and revealed a series of themes. These were falls as a threat to personal identity, falls as a threat to independence, falls as a threat to social interaction and carefulness as a protective strategy. CONCLUSION: Many older people reject the label of "at risk of falling" because of the perceived implication of dependency and incompetence. To be considered "at risk" of falling is perceived as threatening the identity of individuals who are comfortable maintaining their own independence. However, there are also those who accept the risk of falling and in doing so choose carefulness as a personal strategy to manage the risk. For the majority of older people, maintaining independence is the key motivator influencing their actions. Independence to pursue social interaction safeguards against loss of identity, social isolation and negative feelings of dependency. Falling in the community is a problem that persists, despite intervention of local health teams. This article contributes to a body of evidence on older people's experience of falling in the community with the aim of providing new insights for nurses as they approach the issues with patients. IMPLICATIONS FOR PRACTICE: Management of falls risk improves through constructive, proactive health behaviour. Promoting a positive attitude towards living well encourages older people to engage in healthy, risk reducing behaviours. Older people reject the designation of "at risk of falling" due to a perceived association with dependency and incompetence. The negative association is a barrier to engaging at-risk populations with fall prevention interventions.