In identifying the contributory factors, this study has shown that a good death can be provided in the community, although it has also revealed many challenges associated with such care. While it could be argued that due to the unpredictability of death, such challenges may always be a threat to effective care anticipatory planning and a recognition that patients need and are entitled to specialist care many of these difficulties could be overcome.

Objectives: global warming poses a serious threat to human health yet healthcare organisations and staff have been relatively slow to engage with sustainable healthcare practises. This review of the literature seeks to frame what is already known about nurses and their views on global warming and sustainable healthcare. Design: eleven primary research papers were sources from a search of five mainstream databases. These papers were subject to a basic thematic analysis.

In the light of these findings, practitioners may face a dilemma when considering the use of acupuncture for migraine. Therefore, large, high quality randomized controlled trials of acupuncture for migraine are needed. Until better quality research is published, with verification of the benefits of acupuncture for migraine, provision of this alternative therapy should not be expanded or withdrawn.

Amyloid beta (Aβ) peptides are notorious for their involvement in Alzheimer's disease (AD), by virtue of their propensity to aggregate to form oligomers, fibrils, and eventually plaques in the brain. Nevertheless, they appear to be essential for correct neurophysiology on the synaptic level and may have additional functions including antimicrobial activity, sealing the blood−brain barrier, promotion of recovery from brain injury, and even tumor suppression. Aβ peptides are also avid copper chelators, and coincidentally copper is significantly dysregulated in the AD brain. Copper (Cu) is released in significant amounts during calcium signaling at the synaptic membrane. Aβ peptides may have a role in maintaining synaptic Cu homeostasis, including as a scavenger for redoxactive Cu and as a chaperone for clearing Cu from the synaptic cleft. Here, we employed the Aβ 1−16 and Aβ 4−16 peptides as well-established non-aggregating models of major Aβ species in healthy and AD brains, and the Ctr 1−14 peptide as a model for the extracellular domain of the human cellular copper transporter protein (Ctr1). With these model peptides and a number of spectroscopic techniques, we investigated whether the Cu complexes of Aβ peptides could provide Ctr1 with either Cu(II) or Cu(I). We found that Aβ 1−16 fully and rapidly delivered Cu(II) to Ctr 1−14 along the affinity gradient. Such delivery was only partial for the Aβ 4−16 /Ctr 1−14 pair, in agreement with the higher complex stability for the former peptide. Moreover, the reaction was very slow and took ca. 40 h to reach equilibrium under the given experimental conditions. In either case of Cu(II) exchange, no intermediate (ternary) species were present in detectable amounts. In contrast, both Aβ species released Cu(I) to Ctr 1−14 rapidly and in a quantitative fashion, but ternary intermediate species were detected in the analysis of XAS data. The results presented here are the first direct evidence of a Cu(I) and Cu(II) transfer between the human Ctr1 and Aβ model peptides. These results are discussed in terms of the fundamental difference between the peptides' Cu(II) complexes (pleiotropic ensemble of open structures of Aβ 1−16 vs the rigid closed-ring system of amino-terminal Cu/Ni binding Aβ 4−16 ) and the similarity of their Cu(I) complexes (both anchored at the tandem His13/His14, bis-His motif). These results indicate that Cu(I) may be more feasible than Cu(II) as the cargo for copper clearance from the synaptic cleft by Aβ peptides and its delivery to Ctr1. The arguments in favor of Cu(I) include the fact that cellular Cu export and uptake proteins (ATPase7A/B and Ctr1, respectively) specifically transport Cu(I), the abundance of extracellular ascorbate reducing agent in the brain, and evidence of a potential associative (hand-off) mechanism of Cu(I) transfer that may mirror the mechanisms of intracellular Cu chaperone proteins.

This article aims to gain intelligence on the impact a foundation degree (FD) has on individuals personally and professionally, and to share the findings with employers and managers along with consideration of the wider implications. The FD is becoming more popular as a vehicle to the assistant practitioner (AP) role. To ensure education budgets are used effectively managers need to assess the value of such programmes. A small-scale mixed method study using a postal questionnaire to gather information from FD graduates was used. Benefits of the FD included: enhanced knowledge at work; enhanced skills at work; an impact on personal performance and on the service provided. Employers and managers encouraged to recognise not just the personal benefits of FD education on their employees but also the wider implications: equity of access to education budgets; acquisition of fundamental values; better recruitment and retention of unregistered workforce; diversification and new ways of working.

The healthcare workforce is changing, and the introduction of assistant practitioner roles in the community presents exciting opportunities for the unregistered workforce. Healthcare assistants wishing to become assistant practitioners are undertaking foundation degrees. During this period of study, they require support and supervision from a mentor to perform competencies; however, mentors are often poorly prepared for this role. This small-scale qualitative exploratory study sought to gain trainee assistant practitioner (TAP), mentor and management perspective on the level of support needed. Findings indicate that TAPs struggle for recognition and student/learner status; there was an assumption that mentors would be adequately equipped to mentor TAPs, and poor mentor preparation was linked to negative student experiences. This article considers the key factors, time and commitment, required to support TAP learners in the workplace. Further, it questions who is best placed to mentor TAPs. Recommendations include an increased level of preparation for mentors, a joint induction programme for TAPs and mentors, a raised profile of the assistant practitioner role within the wider healthcare team, recognition of the TAP as a learner, and allocated time for quality mentorship.

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Purpose – The purpose of this case study is to detail the development of a bespoke programme of learning for Support Workers employed in the mental health sector. Design/methodology/approach – The programme was designed to serve three purposes: to offer a route into mental health nursing; to upskill those who wanted to remain as a Support Worker; to improve the quality of care provided. Findings – The paper shares the perspectives of the local Partnership Trust, a Support Worker on the programme and the Programme Director. Originality/value – Employers within the mental health sector are encouraged to develop their own staff and universities are urged to think differently about curriculum design.