Norwich University

Ethical awareness is fundamental to nursing and midwifery practice, influencing how students recognize and respond to ethical dilemmas in clinical settings. While ethics is well covered in nursing curricula, gaps often remain between theoretical knowledge and practical application. This study aimed to assess the levels of ethical knowledge, perception, and awareness among undergraduate nursing and midwifery students at Babcock University, Nigeria, and to examine the relationships among these constructs. A descriptive cross-sectional design was employed. A total of 206 undergraduate nursing and midwifery students were surveyed using a structured, self-administered questionnaire. Data were analyzed using descriptive statistics, correlation analysis, and regression models to determine associations between ethical knowledge, perception, and awareness. Most students demonstrated high knowledge of general ethical principles, with nearly all respondents familiar with patient rights and informed consent. Positive perceptions of ethics were more strongly correlated with ethical awareness ( r = 0.42, p < .001) than knowledge alone ( r = 0.29, p < .001). Regression analysis confirmed perception as a stronger predictor of ethical awareness. Furthermore, senior-level students with greater clinical exposure had significantly higher ethical awareness. While gender was reported in the demographics (87.4% female, 12.6% male), no statistical test demonstrated gender as a determinant of awareness. The findings highlight that while factual knowledge of ethics is strong, students' perceptions and experiential learning play a more decisive role in shaping ethical awareness. Ethics education should therefore emphasize reflective, practice-based, and culturally sensitive approaches to better prepare students for complex clinical decision-making. La conciencia ética es fundamental en la práctica de enfermería y partería, ya que influye en cómo los estudiantes reconocen y responden a los dilemas éticos en los entornos clínicos. Aunque la ética está ampliamente cubierta en los planes de estudio de enfermería, suelen existir brechas entre el conocimiento teórico y la aplicación práctica. Este estudio tuvo como objetivo evaluar los niveles de conocimiento, percepción y conciencia ética entre estudiantes de licenciatura en enfermería y partería de la Universidad Babcock, Nigeria, y examinar las relaciones entre estos constructos. Se empleó un diseño descriptivo transversal. Un total de 206 estudiantes de licenciatura en enfermería y partería fueron encuestados mediante un cuestionario estructurado y autoadministrado. Los datos se analizaron utilizando estadística descriptiva, análisis de correlación y modelos de regresión para determinar asociaciones entre conocimiento, percepción y conciencia ética. La mayoría de los estudiantes demostró un alto conocimiento de los principios éticos generales, con casi todos los encuestados familiarizados con los derechos del paciente y el consentimiento informado. Las percepciones positivas sobre la ética se correlacionaron más fuertemente con la conciencia ética ( r = 0.42, p < .001) que el conocimiento por sí solo ( r = 0.29, p < .001). El análisis de regresión confirmó la percepción como un predictor más fuerte de la conciencia ética. Además, los estudiantes de niveles avanzados con mayor exposición clínica presentaron una conciencia ética significativamente más alta. Aunque el género se reportó en la demografía (87.4% mujeres, 12.6% hombres), ninguna prueba estadística mostró al género como determinante de la conciencia. Los hallazgos destacan que, si bien el conocimiento factual de la ética es sólido, las percepciones de los estudiantes y el aprendizaje experiencial desempeñan un papel más decisivo en la formación de la conciencia ética. Por lo tanto, la educación en ética debe enfatizar enfoques reflexivos, prácticos y culturalmente sensibles para preparar mejor a los estudiantes frente a la toma de decisiones clínicas complejas.

Epidemiological, PET imaging, genome-wide association and animal research suggests inflammation contributes to Alzheimer's disease (AD) and other dementias, however there is no consensus on its precise contribution. Human and animal studies show acute systemic inflammation, arising from infection, fracture or co-morbid inflammatory disease, accelerate dementia. ASCRIBED aimed to investigate the relationship between acute hip fracture, inflammation and brain injury in dementia. Participants were recruited with dementia and hip fracture, those with hip fractures but no dementia, and a control group of individuals with dementia but no acute illness or injury. Cerebrospinal fluid (CSF) and blood samples were collected to measure inflammatory markers and brain injury biomarkers. We recruited from 37 UK hospital sites, drawing CSF and blood from participants with dementia and hip fracture (n=191), participants with no dementia and hip fracture (n=218), participants with confusion and hip fracture (n=80) and a Norwegian cohort of community-dwelling participants with dementia (n=181). Most participants were women (68%) across the groups. APOE3/E3 was the commonest genotype in UK samples (mean 56%). Multi-morbidity as measured by the Charlson index was highest in the dementia fracture group. Despite the stable dementia group showing the expected CSF elevation in phosphoTau (p<0.001) and reduction in CSF Ab1-42 (p<0.001) compared to all other groups, the axonal damage marker neurofilament light chain (NFL) was significantly higher in those with hip fracture than in stable dementia and was highest in those with hip fracture and dementia (p<0.001). CSF NFL levels were correlated most strongly with blood CSF barrier permeability, as measured by Qalbumin (p<0.001). Our findings show hip fracture leads to an increase in axonal injury, significantly beyond that observed in patients with stable dementia. This acute injury appears more severe in those with existing dementia. Additionally, NFL levels were correlated with blood CSF barrier permeability which may suggest a link between axonal damage and BBB disruption. Further research is needed to elucidate the underlying mechanisms of this acute brain injury and explore potential therapeutic interventions.

Introduction: Sickle cell disease (SCD) is a significant public health concern in Nigeria, affecting an estimated 2%–3% of the population. Premarital genetic counselling (PGC) plays a crucial role in preventing SCD by informing individuals about genetic risks and inheritance patterns. Despite its importance, the awareness and uptake of PGC remain suboptimal among young adults, particularly in university settings. Aim: This study aimed to investigate the awareness, knowledge, and perceptions of premarital genetic counselling for SCD prevention among female undergraduate students at Babcock University, Nigeria. The study seeks to identify the gaps in understanding and barriers to engagement with PGC among this key demographic. Methodology: A descriptive quantitative survey design was employed, using a multistage sampling technique to select 344 female students from various academic levels at Babcock University. Data were collected using a structured questionnaire that assessed knowledge of PGC, perceived susceptibility to SCD, and attitudes toward genetic counselling. The data were analyzed using descriptive and inferential statistics, including regression analyses to examine the relationships between the knowledge and perceptions of SCD. Results: The study found that 66.8% of participants were aware of premarital genetic counselling, although misconceptions persisted, with 27.3% erroneously believing that SCD could be transmitted via direct contact or mosquito bites. A regression analysis revealed significant positive relationships between knowledge and perceived susceptibility (β = 1.34, R² = 0.91) and perceived seriousness (β = 0.93, R² = 0.94) of SCD. Demographic factors such as age, marital status, ethnicity, and religion were found to significantly influence awareness levels. Conclusion: The findings underscore the importance of addressing the misconceptions and knowledge gaps about SCD and genetic counselling. Targeted educational interventions, especially those tailored to demographic and cultural factors, are essential to improve awareness and promote preventive behaviors. Expanding the access to PGC services and integrating SCD education into curricula are crucial steps in reducing the burden of SCD in Nigeria.

The emergence of nanopore sequencing technology has the potential to transform metagenomics by offering low-cost, portable, and long-read sequencing capabilities. Furthermore, these platforms enable real-time data generation, which could significantly reduce the time from sample collection to result, a crucial factor for point-of-care diagnostics and biosurveillance. However, the full potential of real-time metagenomics remains largely unfulfilled due to a lack of accessible, open-source bioinformatic tools. We present Metagenomic Analysis in Real-Time (MARTi), an innovative open-source software designed for the real-time analysis, visualization, and exploration of metagenomic data. MARTi supports various classification methods, including BLAST, Centrifuge, and Kraken2, letting users customize parameters and utilize their own databases for taxonomic classification and antimicrobial resistance analysis. With a user-friendly, browser-based graphical interface, MARTi provides dynamic, real-time updates on community composition and AMR gene identification. MARTi's architecture and operational flexibility make it suitable for diverse research applications, ranging from in-field analysis to large-scale metagenomic studies. Using both simulated and real-world data, we demonstrate MARTi's performance in read classification, taxon detection, and relative abundance estimation. By bridging the gap between sequencing and actionable insights, MARTi marks a significant advance in the accessibility and functionality of real-time metagenomic analysis.

ObjectivesAlthough the concept of overdiagnosis was first referenced in MEDLINE 100 years ago, consensus on a clear definition has been lacking. In 2021, the MeSH term “Overdiagnosis” was officially introduced, which defined the concept. A key goal of the new term is to improve the reliability of literature searches and enhance the conceptual understanding of overdiagnosis.MethodsWe conducted a systematic bibliometric review of all citations indexed under the MeSH term for “Overdiagnosis” in MEDLINE. We compared the citations with citations identified through a text‐word search for overdiagnosis not indexed under the MeSH term. Searches were performed on 15 September 2024.ResultsWe found that a higher percentage of citations indexed under the new MeSH term used it according to the definition compared with the text‐word search (73.2% vs. 49.5%). The remainder used the term to describe misdiagnosis, false positives, and overtreatment. The citations indexed under the MeSH term were primarily descriptive in nature (68.7%), focusing on oncology (54.2%) and screening practices (31.2%).DiscussionDespite advancements, the field of overdiagnosis is still in its early stages, with potential for expansion into studies addressing prevention and mitigation strategies. The introduction of the MeSH term has facilitated some degree of conceptual alignment.ConclusionOur review provides insights into the current state of the overdiagnosis literature, emphasising prevalent themes and areas for further research, and improvements in MeSH indexing accuracy. Residual conceptual ambiguity surrounding overdiagnosis terminology and indexing practices may explain discrepancies in MeSH categorisation and definition adherence.

BackgroundThis quantitative study engaged volunteer participants and a scavenger hunt application with the purpose of collecting photographic data of the breadth and scope of violations of the World Health Organization’s Code of Marketing of Breast-milk Substitutes (“the Code”) and subsequent World Health Assembly Resolutions, in four industrialized countries– the United States (“U.S.”), Canada, Australia and the United Kingdom (“U.K.”). These four countries do not have or do not adequately enforce their related polices or laws. A secondary goal was to provide evidence to inform national strategic planning efforts related to the marketing practices of manufacturers and distributors of breast-milk substitutes (BMS).MethodsParticipants had to be residents of either the U.S., Australia, Canada or the U.K., and had to be 18 years old at minimum. They were recruited via social media, conference attendance and professional networks. Participants completed a demographic survey and downloaded the scavenger hunt application onto their mobile devices. The application directed participants to fulfill as many of the thirty total “missions,” which were provided by the research team, by uploading photographic evidence of images that they believed were examples of breaches of the Code. Data collection occurred from July 19, 2023 through July 31, 2024. The research team assessed, recategorized and calculated the numbers of participant submissions after the data collection phase. The Statistical Package for the Social Sciences software was utilized to conduct descriptive statistics, including Pearson’s chi-squared and residuals.ResultsIn total, 738 individuals were eligible and consented to participation in the study. Of those individuals, 323 continued on to the scavenger hunt application. After evaluation by the research team to assess if participant submissions were submitted under the appropriate “mission” within the application, and then if their submission qualified as a true violation of the Code, 138 submitted violations were verified and included in the analysis. Key findings include the prevalence of digital marketing violations across all four countries, false, unsubstantiated marketing claims on BMS, a lack of key instructions on the preparation, handling and storage on labels of infant formula products and the marketing violations of BMS in healthcare facilities.ConclusionsBreaches of the Code are prevalent across the U.S., the U.K., Australia and Canada and expose the public to misleading marketing tactics. To safeguard breastfeeding from exploitative digital marketing practices, countries must legislate the Code into national law and commit to its implementation through advocacy, policy and enactment.

The uptake of robotic-assisted colorectal surgery (RACS) across the UK and Ireland has increased exponentially over the last 5 years. It is anticipated that most 'conventional' laparoscopic procedures will eventually move to a robotic approach within a National Health Service that is committed to embracing robotic-assisted surgery. Working in collaboration with the surgical Royal Colleges, a more structured framework is necessary for robotic training. Inequality in robotic access and the impact that RACS is having on current colorectal surgical trainees need to be addressed, The Association of Coloproctology of Great Britain and Ireland (ACPGBI) has set out a framework to help support training in RACS at basic, advanced and trainer levels. Safer, better-trained robotic surgeons will ensure improved patient outcomes, which is the overriding goal of the ACPGBI.

Ivermectin (IVR), whose discovery has beenNobel-Prize-honored,is a 16-membered macrocyclic lactone used in medicine as an extremelyeffective and safe antiparasitic drug. In recent years, interest inthis compound has grown due to its potential effectiveness in killingvarious types of cancer cells. However, research on the anticanceractivity of IVR derivatives is limited. Additionally,the growing problem of drug resistance raises concerns about the effectivenessof this drug in the treatment of parasitic diseases. Therefore, inthis work, we provide a detailed description of the synthesis of tennew IVR bioconjugates with compounds exhibiting highanticancer and/or antimicrobial activity. We also assess the effectivenessof these hybrids in killing Trypanosoma brucei brucei a protozoan parasite that causes African trypanosomiasis, as wellas their anticancer activity toward various cancer cell lines. Manyof the newly synthesized conjugates exhibited higher biological activitythan their respective parent compounds as well as increased selectivityindices. The IVR conjugate with artesunate (compound 16) appears particularly interesting, as it proved not onlyto be several times more active than the parent compounds but alsoshowed no toxicity toward a reference cell line, indicating its potentialas a therapeutic agent.

Abstract Life Story Work is a fundamental in children’s state care. It is a process of helping children make sense of their experiences to promote their well-being. As society increasingly uses online repositories to store digital artefacts, interest in commissioning Digital Life Story Work (DLSW) platforms grows. However, why, how, when, for whom, and in what circumstances such platforms may help support children with experience of living in state care is unknown. Addressing this gap, we report on the first widespread rollout of a DLSW platform across one English Local Authority. Utilizing a participatory realist evaluation approach, we collected data from 119 participants and involved peer-researchers throughout. This article presents our final programme theory. This illustrates that DLSW is more likely to be optimal when it is: flexible and person-centred; provides future storytelling prompts; starts early; begins in the present; involves children, and constantly offers participation choices; records all aspects of everyday experiences and; when appropriate training and support is available. Findings provide key considerations for commissioners and implementers and begin to build a picture of how DLSW platforms may become embedded in supporting children with experience of living in state care.