The knowledge and attitudes regarding pressure ulcer prevention among healthcare support workers in the UK: A cross-sectional study.

BACKGROUND: Pressure ulcers cause significant, detrimental effects on personal wellbeing. They represent a serious health and social care burden. Nurses and those working in support roles are primarily accountable for preventing pressure ulcers. Healthcare support workers are an expanding group of key workers in the UK. OBJECTIVE: To examine healthcare support workers' knowledge and attitudes regarding pressure ulcer prevention. METHODS: A cross-sectional study was conducted from December 2020 to June 2021, using Knowledge and Attitudes toward Pressure Ulcer Prevention Assessment Tool. RESULTS: A total of 164 participants completed the questionnaire fully. A low mean knowledge score of 0.42 ± 0.14, but a positive attitude score of 0.76 ± 0.10 per item were reported. The weakest areas of knowledge include aetiology, risk assessment and addressing pressure-reducing interventions for patients at risk. Higher mean scores per item in knowledge of pressure ulcer prevention were reported in participants working in acute hospital wards and nursing homes (0.468 ± 0.15, 0.47 ± 0.08 respectively) than those in other settings (p < 0.05). Participants working in primary care scored lowest (0.33 ± 0.12). The scores of participants with more positive attitudes towards pressure ulcer prevention significantly correlated with higher score of knowledge (p < 0.005). CONCLUSION: While positive attitudes towards pressure ulcer prevention exist among healthcare support workers, this is overshadowed by significant knowledge deficits. Findings highlight the importance of continuing structured education for support workers across both acute and community settings. A future national survey and interventional study are needed to examine support workers' pressure ulcer knowledge and to inform a national continuous education strategy.

Studying the old masters of nursing: A critical student experience for developing nursing identity.

In the past professional identity in nursing was inculcated in students alongside institutional pride. A strong sense of professional identity is key to staff retention and recruitment and key to the delivery of quality nursing care. With the wholesale transfer of pre-registration nursing education to the third level sector, however, the reality is that students now divide their affiliations between university and healthcare institutions and professional identity development may be stymied. For this reason, there is need to explore alternative means of developing professional identity. Exposure to nursing history may counteract this tendency. Based on adult nursing students' reflections of a visit to the Florence Nightingale Museum, we discuss the potential of this activity in aiding development of critical professional identity.

Representation of age and ageing identities in popular music texts.

AIMS: To critically examine the representation of ageing identities in popular music texts. BACKGROUND: Having a positive outlook provides both short-term benefits and has been proven to help people live longer. Music is capable of conveying positive and negative emotion towards ageing, however, only a limited number of unpublished studies exist on how age and ageing is represented in popular music. DESIGN: Qualitative discourse analysis. METHODS: In July 2014, a search without time limits was completed of the music lyrics databases, The Music Lyric Database, Songfacts, The Macronium and Absolute lyrics for English language music texts relating to age and ageing. RESULTS: Findings revealed (N = 76) relevant music texts offering up negative and positive discourses of age and ageing, with negative predominating. Identities of age and ageing were categorized as 'contented and celebrated aged', 'pitiful and petulant pensioners' and 'frail and flagging old folks'. CONCLUSION: From this study, it is evident that mainly negative representations of age and ageing are available in popular music texts. It is imagined that the negative representations of age and ageing can be dispiriting, confidence and esteem lowering for older people and their potential impact might be considered carefully by artists. However, while evidence exists that negative and positive emotions can influence health and well-being, further qualitative research is needed to explore what impact precisely the negative texts have on those experiencing ageing.

Adaptation of a Cell-Based High Content Screening System for the In-Depth Analysis of Celiac Biopsy Tissue.

The IN Cell Analyzer 1000 possesses several distinguishing features that make it a valuable tool in research today. This fully automated high content screening (HCS) system introduced quantitative fluorescent microscopy with computerized image analysis for use in cell-based analysis. Previous studies have focused on live cell assays, where it has proven to be a powerful and robust method capable of providing reproducible, quantitative data. Using HCS as a tool to investigate antigen expression in duodenal biopsies, we developed a novel approach to tissue positioning and mapping. We adapted IN Cell Analyzer 1000's image acquisition and analysis software for the investigation of tissue transglutaminase (tTG) and smooth muscle alpha-actin (SM α-actin) staining in paraffin-embedded duodenal tissue sections from celiac patients and healthy controls. These innovations allowed a quantitative analysis of cellular structure and protein expression. The results from routine biopsy material indicated the intensity of protein expression was altered in celiac disease compared to normal biopsy material.

IgG anti-tTG responses in different autoimmune conditions differ in their epitope targets and subclass usage.

Antibodies of the IgA class directed against the enzyme tissue transglutaminase (tTG) are highly specific for coeliac disease (CD). IgG antibodies to tTG also occur in CD, and have also been reported in autoimmune diseases such as type 1 diabetes mellitus and Crohn's disease. In comparison to the IgA anti-tTG response, little is known of the IgG anti-tTG response in terms of epitope specificity and IgG subclass usage. The aim of this study was to investigate and compare epitopes recognised by CD and non-CD IgG anti-tTG antibodies, and determine the relative proportions of the IgG subclasses comprising this response. IgG anti-tTG positive individuals who did not have CD were identified by screening groups of patients with type I diabetes mellitus, Crohn's disease and granulomatosis with polyangiitis. Results from ELISA blocking experiments and mutant tTG antigens demonstrate that non-CD IgG anti-tTG bind different epitopic determinants to CD IgG anti-tTG. The IgG subclass usage of coeliac disease and type 1 diabetes was dominated by IgG1, whereas this IgG subclass was infrequently a component of the IgG anti-tTG response in diseases such as granulomatosis with polyangiitis and Crohn's disease. The differences in epitope specificity and subclass usage of IgG anti-tTG observed between CD and non-CD individuals may be due to the differing mechanisms underlying tTG autoimmunity.

An integrative review of the literature on the teaching of the history of nursing in pre-registration adult nursing education in the UK.

AIMS: To present an integrative review of literature on the teaching of nursing history in pre-registration adult nursing education. BACKGROUND: Despite successive reconfigurations in healthcare systems and education policy, the teaching of the history of nursing remains contested in pre-registration curricula. Recent curriculum reviews acknowledge the need for systematic study of nursing education. To date in the UK, there has been no systematic review of the literature on the teaching of nursing history in pre-registration training programmes. DESIGN: An integrative review of the literature. DATA SOURCES: A search of the electronic databases of CINAHL (1982-2013), HMIC (1979-2013), BNI (1994-2013) and MEDLINE (Pub Med) (1966-2013) was concluded in January 2014, using the keywords 'adult nursing', 'history' 'pre-registration', 'education' and 'teaching'. REVIEW METHODS: An integrative literature review was conducted. Identified titles and abstracts were screened separately by researchers for relevance and eligibility and papers were independently assessed for inclusion. Data were abstracted from included papers and quality evaluation of included papers was conducted. The papers were analysed and reported in a narrative synthesis. RESULTS: Twelve papers were selected for review. The majority of articles were discursive papers and there was a paucity of empirical reports. Content indicated concerns for teaching nursing history in regard to curriculum policy and methods of teaching and assessment. CONCLUSIONS: Substantial support exists for mandatory inclusion of the teaching of historical literacy in nursing centred on the themes of health and disease, hegemony, nursing work and image and ideology. Due to space and teaching expertise issues this could ideally be achieved through the use of nursing museum visits, the usefulness of which could be critically explored in future research.

Characterisation of tissue transglutaminase-reactive T cells from patients with coeliac disease and healthy controls.

Previous studies have shown evidence for T lymphocytes specific for tissue transglutaminase (tTG) in the periphery of coeliac disease (CD) patients. These cells could play a role in disease pathogenesis and may be involved in providing help for the production of anti-tTG autoantibodies. The objective of this study was to further investigate the presence of tTG-specific T cells in patients with treated and untreated CD, and normal controls. Positive proliferative responses to three different commercial tTG antigens were detected in all groups tested, occurring more frequently and at higher levels in untreated CD patients. The addition of antibodies to HLA-DQ and HLA-DR caused a significant reduction in the proliferative response to tTG. T cell lines specific for tTG and composed predominantly of CD4-positive T cells were generated from responsive CD and control individuals, and were found to produce large amounts of interferon-γ, as well as interleukins 10, 17A, and 21.

Instrument development and validation of a quality scale for historical research papers (QSHRP): a pilot study.

AIM: To report a pilot study for the development and validation of an instrument to measure quality in historical research papers. BACKGROUND: There are no set criteria to assess historical papers published in nursing journals. DESIGN: A three phase mixed method sequential confirmatory design. METHODS: In 2012, we used a three-phase approach to item generation and content evaluation. In phase 1, we consulted nursing historians using an online survey comprising three open-ended questions and revised the items. In phase 2, we evaluated the revised items for relevance with expert historians using a 4-point Likert scale and Content Validity Index calculation. In phase 3, we conducted reliability testing of the instrument using a 3-point Likert scale. RESULTS: In phase 1, 121 responses were generated via the online survey and revised to 40 interrogatively phrased items. In phase 2, five items with an Item Content Validity Index score of ≥0·7 remained. In phase 3, responses from historians resulted in 100% agreement to questions 1, 2 and 4 and 89% and 78%, respectively, to questions 3 and 5. CONCLUSION: Items for the QSHRP have been identified, content validated and reliability tested. This scale improves on previous scales, which over-emphasized source criticism. However, a full-scale study is needed with nursing historians to increase its robustness.

Persistent changes in circulating and intestinal γδ T cell subsets, invariant natural killer T cells and mucosal-associated invariant T cells in children and adults with coeliac disease.

Coeliac disease is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals. The only current therapy is a lifelong gluten free diet. While much work has focused on the gliadin-specific adaptive immune response in coeliac disease, little is understood about the involvement of the innate immune system. Here we used multi-colour flow cytometry to determine the number and frequency of γδ T cells (Vδ1, Vδ2 and Vδ3 subsets), natural killer cells, CD56(+) T cells, invariant NKT cells, and mucosal associated invariant T cells, in blood and duodenum from adults and children with coeliac disease and healthy matched controls. All circulating innate lymphocyte populations were significantly decreased in adult, but not paediatric coeliac donors, when compared with healthy controls. Within the normal small intestine, we noted that Vδ3 cells were the most abundant γδ T cell type in the adult epithelium and lamina propria, and in the paediatric lamina propria. In contrast, patients with coeliac disease showed skewing toward a predominant Vδ1 profile, observed for both adult and paediatric coeliac disease cohorts, particularly within the gut epithelium. This was concurrent with decreases in all other gut lymphocyte subsets, suggesting a specific involvement of Vδ1 cells in coeliac disease pathogenesis. Further analysis showed that γδ T cells isolated from the coeliac gut display an activated, effector memory phenotype, and retain the ability to rapidly respond to in vitro stimulation. A profound loss of CD56 expression in all lymphocyte populations was noted in the coeliac gut. These findings demonstrate a sustained aberrant innate lymphocyte profile in coeliac disease patients of all ages, persisting even after elimination of gluten from the diet. This may lead to impaired immunity, and could potentially account for the increased incidence of autoimmune co-morbidity.