An Evaluation of a Student Allied Health Professions’ Social Prescribing Scheme

Purpose: Social prescribing is a core part of healthcare policy within the NHS and requires support and contributions from all healthcare professionals, including Allied Healthcare Professionals (AHPs). The well-established medical student-led social prescribing student champion scheme (SPSCS) has been expanded to include AHPs, and AHP champions were recruited to deliver peer-led activities focused on social prescribing. This article aimed to evaluate the impact of the scheme\u27s expansion on AHP students. Method: Fourteen AHP champions ran 21 activities that reached 524 students. Those participating in the champion-led activities were asked to complete pre- and post-session surveys to capture the impact of the sessions on their awareness of, knowledge of, and confidence with clinically applying social prescribing. Participants also rated the opportunity for multi-disciplinary interaction and overall experience of the champion led activities. Results: It was found that participant’s post-session scores for awareness, understanding and confidence were higher than post-session scores. Further, post-session survey results showed that participants enjoyed and felt they had been able to experience multi-disciplinary interaction at events. Conclusions: In summary, the evaluation of the AHP SPSCS highlights the value of student-led peer teaching in helping to raise awareness and understanding about social prescribing for AHP students, whilst acknowledging the need to expand the scheme’s reach in the future

An evaluation of a student allied health professions’ social prescribing scheme

Purpose: Social prescribing is a core part of healthcare policy within the NHS and requires support and contributions from all healthcare professionals, including Allied Healthcare Professionals (AHPs). The well-established medical student-led social prescribing student champion scheme (SPSCS) has been expanded to include AHPs, and AHP champions were recruited to deliver peer-led activities focused on social prescribing. This article aimed to evaluate the impact of the scheme's expansion on AHP students. Method: Fourteen AHP champions ran 21 activities that reached 524 students. Those participating in the champion-led activities were asked to complete pre- and post-session surveys to capture the impact of the sessions on their awareness of, knowledge of, and confidence with clinically applying social prescribing. Participants also rated the opportunity for multi-disciplinary interaction and overall experience of the champion led activities. Results: It was found that participant’s post-session scores for awareness, understanding and confidence were higher than post-session scores. Further, post-session survey results showed that participants enjoyed and felt they had been able to experience multi-disciplinary interaction at events. Conclusions: In summary, the evaluation of the AHP SPSCS highlights the value of student-led peer teaching in helping to raise awareness and understanding about social prescribing for AHP students, whilst acknowledging the need to expand the scheme’s reach in the future

Social Structure of Lions (Panthera leo) Is Affected by Management in Pendjari Biosphere Reserve, Benin

Lion populations have undergone a severe decline in West Africa. As baseline for conservation management, we assessed the group structure of lions in the Pendjari Biosphere Reserve in Benin. This reserve, composed of one National Park and two Hunting Zones, is part of the WAP transboundary complex of protected areas. Overall mean group size was 2.661.7 individuals (n = 296), it was significantly higher in the National Park (2.761.7, n = 168) than in the Hunting Zones (2.261.5, n = 128). Overall adult sex ratio was even, but significantly biased towards females (0.67) in the National Park and towards males (1.67) in the Hunting Zones. Our results suggest that the Pendjari lion population is affected by perturbations, such as trophy hunting.Conservation Biolog

Genotype, age, genetic background, and sex influence Epha2-related cataract development in mice

Purpose: Age-related cataract is the leading cause of blindness worldwide. Variants in the EPHA2 gene increase the disease risk, and its knockout in mice causes cataract. We investigated whether age, sex, and genetic background, risk factors for age-related cataract, and Epha2 genotype influence Epha2-related cataract development in mice. Methods: Cataract development was monitored in Epha2+/+, Epha2+/−, and Epha2−/− mice (Epha2Gt(KST085)Byg) on C57BL/6J and FVB:C57BL/6J (50:50) backgrounds. Cellular architecture of lenses, endoplasmic reticulum (ER) stress, and redox state were determined using histological, molecular, and analytical techniques. Results: Epha2−/− and Epha2+/− mice on C57BL/6J background developed severe cortical cataracts by 18 and 38 weeks of age, respectively, compared to development of similar cataract significantly later in Epha2−/− mice and no cataract in Epha2+/− mice in this strain on FVB background, which was previously reported. On FVB:C57BL/6J background, Epha2−/− mice developed severe cortical cataract by 38 weeks and Epha2+/− mice exhibited mild cortical cataract up to 64 weeks of age. Progression of cataract in Epha2−/− and Epha2+/− female mice on C57BL/6J and mixed background, respectively, was slower than in matched male mice. N-cadherin and β-catenin immunolabeling showed disorganized lens fiber cells and disruption of lens architecture in Epha2−/− and Epha2+/− lenses, coinciding with development of severe cataracts. EPHA2 immunolabeling showed intracellular accumulation of the mutant EPHA2-β-galactosidase fusion protein that induced a cytoprotective ER stress response and in Epha2+/− lenses was also accompanied by glutathione redox imbalance. Conclusions: Both, Epha2−/− and Epha2+/− mice develop age-related cortical cataract; age as a function of Epha2 genotype, sex, and genetic background influence Epha2-related cataractogenesis in mice

Growth factor restriction impedes progression of wound healing following cataract surgery: identification of VEGF as a putative therapeutic target

Secondary visual loss occurs in millions of patients due to a wound-healing response, known as posterior capsule opacification (PCO), following cataract surgery. An intraocular lens (IOL) is implanted into residual lens tissue, known as the capsular bag, following cataract removal. Standard IOLs allow the anterior and posterior capsules to become physically connected. This places pressure on the IOL and improves contact with the underlying posterior capsule. New open bag IOL designs separate the anterior capsule and posterior capsules and further reduce PCO incidence. It is hypothesised that this results from reduced cytokine availability due to greater irrigation of the bag. We therefore explored the role of growth factor restriction on PCO using human lens cell and tissue culture models. We demonstrate that cytokine dilution, by increasing medium volume, significantly reduced cell coverage in both closed and open capsular bag models. This coincided with reduced cell density and myofibroblast formation. A screen of 27 cytokines identified nine candidates whose expression profile correlated with growth. In particular, VEGF was found to regulate cell survival, growth and myofibroblast formation. VEGF provides a therapeutic target to further manage PCO development and will yield best results when used in conjunction with open bag IOL designs

Nel positively regulates the genesis of retinal ganglion cells by promoting their differentiation and survival during development

Peer reviewedPublisher PD

Ultrastructural pathology of primary ciliary dyskinesia: report about 125 cases in Germany

<p>Abstract</p> <p>Background</p> <p>Primary ciliary dyskinesia (PCD) is a rare genetically induced disorder of cilia inducing mainly respiratory diseases. Transmission electron microscopy (TEM) analysis of ciliary ultrastructure is classically used for diagnosis. We report our experience of TEM investigations in a large series of patients.</p> <p>Methods</p> <p>TEM analysis performed of 742 biopsies from patients with suspected PCD was reviewed retrospectively. Ultrastructural defects were analysized further in 125 cases with changes typical for PCD.</p> <p>Results</p> <p>In 18.1% of patients diagnosis of PCD was made because of morphological alterations, in 68.2% secondary changes were seen. In 13.7% material was not feasible for analysis. Mostly defects of dynein arms were detected in PCD (96.8%). In particular defects of the inner arms (51.2%) and combined dynein defects (37.6%) were found. Total loss of dynein arms was dominant. Only in 3.2% deficiencies of central structures were found alone. Associated situs inversus or dextracardia was reported clinically in 21.4%.</p> <p>Conclusions</p> <p>TEM analysis is possible in most patients and a useful tool for diagnosis of PCD. Functional and genetic analysis should be done additionally. Registers should be installed to collect all available informations and push further research.</p

Breeding performance of the grasshopper buzzard (<i>Butastur rufipennis</i>) in a natural and a human-modified West African savanna

Few studies have examined raptor reproduction in response to land-use change in sub-Saharan Africa, hampering conservation efforts to address regional declines. To further our understanding of mechanisms underlying the dramatic declines of West African raptors, we examined the relationship between environmental conditions, nest density, and measures of reproduction in the Grasshopper Buzzard (Butastur rufipennis). Analyses were based on 244 nest sites divided between transformed and natural habitat in northern Cameroon. At the landscape scale, nest density increased with the density of preferred nest trees. Nests were more widely spaced in transformed than in natural habitat. Dispersion was adjusted to differences in availability of small mammals, which was negatively associated with distance to nearest neighbor, and in the area under cultivation, which was positively associated with distance to nearest neighbor. Productivity was positively associated with rainfall, canopy shielding the nest, availability of grasshoppers, and the nest's visibility from ground level; canopy shielding, grass cover, rainfall, and distance to nearest neighbor were positively associated with nest success. In natural habitat, losses of eggs and nestlings to natural predators were greater than in transformed habitats, while losses through human predation were small. Productivity and nest success were unaffected by land use because of the opposing effects of greater predation pressure, closer spacing of nests, and more food in natural habitat than in transformed habitat. Thus transformed habitat may provide adequate breeding habitat for the Grasshopper Buzzard, but declining rainfall and intensifying anthropogenic land use are likely to affect future reproductive output

Nurses' 12-hour shifts and missed or delayed vital signs observations on hospital wards: retrospective observational study

Objectives 12-hour shifts worked by nurses on acute hospital wards have been associated with increased rates of missed care reported by nurses. This study aimed to measure the association between nurses working shifts of at least 12 hours and an objective measure of missed care: vital signs observations taken on time according to an acuity-based surveillance protocol. Design A retrospective observational study using routinely collected data from March 2012 to March 2015. Setting 32 general inpatient wards at a large acute hospital in England. Participants 658 628 nursing shifts nested in 24 069 ward days. Outcome measures The rate of daily delayed and missed vital signs observations. We focused on situations where vital signs observations were required at least every 4 hours and measured the number of instances where observations were delayed or missed, per 24-hour period. For each ward and each day, shift patterns were characterised in terms of proportion of care hours per patient day deriving from 'long' shifts (>= 12 hours) for both registered nurses and healthcare assistants. Results On 99 043 occasions (53%), observations were significantly delayed, and on 81 568 occasions (44%), observations were missed. Observations were more likely to be delayed when a higher proportion of the hours worked by healthcare assistants were part of long shifts (IRR=1.05; 95% CI 1.00 to 1.10). No significant association was found in relation to the proportion of hours registered nurses worked as long shifts. Conclusion On days when a higher proportion of hours worked by healthcare assistants are from long shifts, the risk of delaying vital signs observations is higher, suggesting lower job performance. While longer shifts are thought to require fewer staff resources to maintain nurse-to-patient ratios, any benefits may be lost if staff become less productive

Mutations in Radial Spoke Head Genes and Ultrastructural Cilia Defects in East-European Cohort of Primary Ciliary Dyskinesia Patients

Primary ciliary dyskinesia (PCD) is a rare (1/20,000), multisystem disease with a complex phenotype caused by the impaired motility of cilia/flagella, usually related to ultrastructural defects of these organelles. Mutations in genes encoding radial spoke head (RSPH) proteins, elements of the ciliary ultrastructure, have been recently described. However, the relative involvement of RSPH genes in PCD pathogenesis remained unknown, due to a small number of PCD families examined for mutations in these genes. The purpose of this study was to estimate the involvement of RSPH4A and RSPH9 in PCD pathogenesis among East Europeans (West Slavs), and to shed more light on ultrastructural ciliary defects caused by mutations in these genes. The coding sequences of RSPH4A and RSPH9 were screened in PCD patients from 184 families, using single strand conformational polymorphism analysis and sequencing. Two previously described (Q109X; R490X) and two new RSPH4A mutations (W356X; IVS3_2–5del), in/around exons 1 and 3, were identified; no mutations were found in RSPH9. We estimate that mutations in RSPH4A, but not in RSPH9, are responsible for 2–3% of cases in the East European PCD population (4% in PCD families without situs inversus; 11% in families preselected for microtubular defects). Analysis of the SNP-haplotype background provided insight into the ancestry of repetitively found mutations (Q109X; R490X; IVS3_2–5del), but further studies involving other PCD cohorts are required to elucidate whether these mutations are specific for Slavic people or spread among other European populations. Ultrastructural defects associated with the mutations were analyzed in the transmission electron microscope images; almost half of the ciliary cross-sections examined in patients with RSPH4A mutations had the microtubule transposition phenotype (9+0 and 8+1 pattern). While microtubule transposition was a prevalent ultrastructural defect in cilia from patients with RSPH4A mutations, similar defects were also observed in PCD patients with mutations in other genes