Staff perceptions of a patient at risk team: A survey design.

INTRODUCTION: Whilst research demonstrates the benefits of critical care outreach, limited research describes staffs' perspective of these teams. OBJECTIVE: This study examined ward nurses' and doctors' perceptions of the service provided by a nurse-led 24hours a day, seven days a week Patient at Risk team. DESIGN: Using an exploratory survey research design and a previously used instrument, data were collected between January and March (2016). The instruments' reliability was assessed using Cronbach's alpha (a=0.90). RESULTS: 339 participants, including 255 nurses and 84 doctors, completed the questionnaire (70.48% response rate). Most participants agreed the Patient at Risk team 1) were accessible and approachable, 2) recognised deterioration and reduced serious events, 3) provided ward staff teaching and coaching and 4) aided allied health referral and improved transfer of patients from critical care. More nurses than doctors perceived the team's role more positively in some aspects of the service they provided. Whilst most comments were positive, some comments identified improvements could be made to the service. CONCLUSION: Ward nurses' and doctors' perceived the Patient at Risk team contributed to improving care of deteriorating ward patients. The instrument used in this study may be useful to other outreach teams to identify service improvements.

PA19†'closing the gap': a community engagement project.

BACKGROUND: Dove House Hospice serves a population of about 600,000 covering Hull and East Riding. About 42% of people in Hull and East Riding die in their usual residence. Dove House Hospice's vision is to provide excellent specialist palliative care and support to patients, their families and carers in the locality. Despite excellent services provided, there was evidence of lack of awareness. A project, using a community engagement approaches, was therefore developed to close this gap. AIM: Raise awareness about death, dying, loss and care; and services provided by Dove House Hospice Improve partnerships between Dove House Hospice and the community. Increase social supports to those who experiences death, dying, loss and caregiving. APPROACH: Two postcode areas, namely Cottingham and Bransholme, were initially selected for two-week community engagement activities. The key approaches used were: direct engagement with the public, participation in community activities, engagement with local primary health care services and distribution of information leaflets. Evaluation approach: Use of pre and post activities questionnaire and feedback meetings with key community members. RESULTS: Leaflets were distributed to a total of about 18,000 addresses. Immediate result include: Increased donation, increased application for volunteering and increased referrals. Community involvement in end of life care waits to be evaluated. CONCLUSION: This is an on-going project. Early indications are that there has been improved awareness of the hospice services and interest in the hospice's activities. The project has also contributed to the hospice being included in the pathfinder charter community.

PrrC from Rhodobacter sphaeroides, a homologue of eukaryotic Sco proteins, is a copper-binding protein and may have a thiol-disulfide oxidoreductase activity.

PrrC from Rhodobacter sphaeroides provides the signal input to a two-component signal transduction system that senses changes in oxygen tension and regulates expression of genes involved in photosynthesis (Eraso, J.M. and Kaplan, S. (2000) Biochemistry 39, 2052-2062; Oh, J.-I. and Kaplan, S. (2000) EMBO J. 19, 4237-4247). It is also a homologue of eukaryotic Sco proteins and each has a C-x-x-x-C-P sequence. In mitochondrial Sco proteins these cysteines appear to be essential for the biogenesis of the CuA centre of respiratory cytochrome oxidase. Overexpression and purification of a water-soluble and monomeric form of PrrC has provided sufficient material for a chemical and spectroscopic study of the properties of the four cysteine residues of PrrC, and its ability to bind divalent cations, including copper. PrrC expressed in the cytoplasm of Escherichia coli binds Ni2+ tightly and the data are consistent with a mononuclear metal site. Following removal of Ni2+ and formation of renatured metal-free rPrrC (apo-PrrC), Cu2+ could be loaded into the reduced form of PrrC to generate a protein with a distinctive UV-visible spectrum, having absorbance with a lambda(max) of 360 nm. The copper:PrrC ratio is consistent with the presence of a mononuclear metal centre. The cysteines of metal-free PrrC oxidise in the presence of air to form two intramolecular disulfide bonds, with one pair being extremely reactive. The cysteine thiols with extreme O2 sensitivity are involved in copper binding in reduced PrrC since the same copper-loaded protein could not be generated using oxidised PrrC. Thus, it appears that PrrC, and probably Sco proteins in general, could have both a thiol-disulfide oxidoreductase function and a copper-binding role.