INQUIRE: a case study in evaluating the potential of online MCQ tests in a discursive subject

There has been a wealth of investigation into the use of online multiple-choice questions as a means of summative assessment, however the research into the use of formative MCQs by the same mode of delivery still remains patchy. Similarly, research and implementation has been largely concentrated within the Sciences and Medicine rather than the more discursive subjects within the Humanities and Social Sciences. The INQUIRE (Interactive Questions Reinforcing Education) Evaluation Project was jointly conducted by two groups at the University of Oxford-the Said Business School and the Academic Computing Development Team to evaluate the use of online MCQs as a mechanism to reinforce and extend student learning. This initial study used a small set of highly focused MCQ tests that were designed to complement an introductory series of first-year undergraduate management lectures. MCQ is a simple and well-established technology, and hence the emphasis was very much on situating the tests within the student experience. The paper will cover how the online MCQs are intended to fit into the Oxford Undergraduate study agenda, and how a simple evaluation was executed and planned to investigate their usage and impact. The chosen method of evaluation was to combine focus groups with automated online methods of tracking, and the paper discusses the findings of both of these

Developing and characterising imaging biomarkers for pain and analgesia

There is a need to improve translation of novel pain treatments from pre-clinical to clinical research, and the development of objective standardised biomarkers to verify target engagement is a vital step towards this goal. Features of chronic pain conditions, such as central sensitisation, can be experimentally induced in healthy humans. Functional magnetic resonance imaging (fMRI) is a highly valuable method to explore the neural basis for pain and also analgesic activity. This thesis combines these two research tools to develop and characterise neuroimaging biomarkers for pain and analgesia. The first chapter consists of a systematic literature review, evidencing that this combination of techniques has provided a wealth of information about brain activity during pain states and analgesia. Co-ordinate based meta-analysis conducted to summarise results for a simple comparison between the neural responses during experimental hyperalgesia compared to control showed activation clusters in the insula cortex and thalamus. Next, exploratory analysis of early 7 Tesla MRI data was conducted to investigate the neural changes that occur during the onset of central sensitisation. Conclusions were limited due to a low sample size, but there were interesting results showing increased blood oxygen-level dependent (BOLD) response in the insula and in the nucleus cuneiformis, a brainstem region shown to be specific to maintenance of central sensitisation. The remaining three chapters comprise primary results and exploratory analysis from the IMI- PainCare BioPain RCT4 trial. The trial utilises the high frequency stimulation (HFS) model to induce central sensitisation, the neural basis for which had not previously been studied using fMRI. Comparison between pre-HFS and post-HFS data showed that the neural basis for HFS-induced central sensitisation was aligned to that seen with the well-characterised capsaicin model in imaging studies. Subsequently, analysis of the main trial endpoints was conducted, to investigate the effects of lacosamide, pregabalin and tapentadol on biomarkers of pain processing observed by fMRI. Pregabalin reduced the punctate-evoked BOLD response in the posterior insula cortex. Lacosamide modulated resting state functional connectivity between the thalamus and secondary somatosensory cortex. In whole-brain analyses, tapentadol modulated responses in areas relevant to pain processing such as the anterior insula cortex. Finally, exploratory analysis was conducted to characterise the placebo effect in the trial, showing that during placebo analgesia changes in brain activity were observed in regions associated with pain perception, including the insula and anterior cingulate cortices, and regions involved in affective and cognitive aspects of pain processing, such as the amygdala and dorsolateral prefrontal cortex. Overall, this work comprises a valuable contribution to increase the utility and standardisation of applying experimental models in conjunction with fMRI in the assessment of novel analgesics prior to large scale clinical trials. As evidenced in the systematic review, individual fMRI studies are highly informative, but lack of standardisation makes comparison between studies difficult. The BioPain work addresses this challenge, providing a standardised assessment of multiple drugs across many pain biomarkers, demonstrating how these biomarkers can be valuably employed in drug development

A consecutive process for C–C and C–N bond formation with high enantio-and diastereocontrol : direct reductive amination of chiral ketones using hydrogenation catalysts

Authors thank the University of St Andrews, and the EPSRC Centre for Doctoral Training in Critical Resource Catalysis (CRITICAT) for financial support [PhD studentship to SG; Grant code: EP/L016419/1].High diastereoselectivity was observed in the Rh-catalysed reductive amination of 3-arylcyclohexanones to form tertiary amines. This was incorporated into a one-pot enantioselective conjugate addition and diastereoselective reductive amination, including an example of assisted tandem catalysis.PostprintPeer reviewe

Review: Delivering mental health support within schools and colleges – a thematic synthesis of barriers and facilitators to implementation of indicated psychological interventions for adolescents

Background: Increasing the role of schools and colleges in the provision of mental health services for young people has the potential to improve early intervention and access to treatment. We aimed to understand what factors influence the successful implementation of indicated psychological interventions within schools and colleges to help guide increased provision of mental health support within education settings. Methods: Systematic search for studies that have reported barriers or facilitators to the implementation of indicated interventions for adolescent emotional disorders delivered within schools and further education/sixth form colleges (CRD42018102830). Databases searched were EMBASE, MEDLINE, PsycINFO, CINAHL, British Nursing Index, ASSIA, ERIC and British Education Index. A thematic synthesis of factors reported to impact implementation was conducted. Results: Two thousand five hundred and sixty-nine records and 177 full texts were screened. Fifty studies were identified for inclusion, all of which were of school-based interventions. Eleven analytic themes were developed encompassing intervention characteristics, organisational capacity, training and technical assistance, provider characteristics and community-level factors. Findings indicate the need to select appropriate interventions, consider logistical challenges of the school context and provide training and supervision to enable staff to deliver interventions with fidelity. However, structural and environmental support is required for these facilitators to have the greatest impact on successful implementation. Conclusions: Implementing indicated school-based mental health interventions is challenging. Those involved in planning school-based mental health initiatives must be alert to the impact of factors on multiple interacting levels. There is a lack of research on implementing mental health support within further education and sixth form colleges

Violence against children perpetrated by peers: A cross-sectional school-based survey in Uganda.

Violence against children by peers is a global public health problem. We aimed to assess factors associated with peer violence victimization among primary school children in Uganda. We conducted multilevel multivariable logistic regression analyses of cross-sectional data from 3706 primary students in 42 Ugandan primary schools. Among primary school students, 29% and 34% had ever experienced physical and emotional violence perpetrated by their peers, respectively. Factors strongly associated with both physical and emotional violence were similar and overlapping, and included exposure to interparental violence, having an attitude supportive of violence against children from school staff, not living with biological parents, working for payment, and higher SDQ score. However, we found that younger age, sharing sleeping area with an adult and achieving a higher educational performance score, were specifically associated with physical violence. On the other hand, being female, walking to school, reporting disability and eating one meal on the previous day, were particularly associated with emotional violence. Interventions to reduce peer violence should focus on family contexts, school environments and those with poor socio-economic status may need extra support

Operationalising generalism in medical education: a narrative review of international policy and mission documents

Introduction Despite moves across medical education to increase learning of generalist principles, a lack of clarity about what generalism means and how we should train doctors as ‘generalists’, has remained. This study explores how international, undergraduate and postgraduate, policy and educational mission documents characterise the practice and learning of generalism and how this can inform physician training. Methods A narrative literature review was conducted based on policy and mission documents identified through grey literature searches and a wider systematic review looking at empirical texts. Texts published between 1999 and present and related to ‘generalism’ were eligible for inclusion. Texts were coded and codes were reviewed and grouped into key themes. Results Thirty-four documents were included. Definitions vary: some described generalism as a basic skill, whilst others emphasised expertise. Factors which support learning generalism include: favourable financial outcomes; ageing populations; coordination of multidisciplinary care; demand for doctors with transferable skills; and patient expectations. Barriers to learning about generalism include: preference for specialisation; structure of undergraduate teaching and assessment; and the hidden curriculum. Solutions may include re-imagining generalists and specialists as being on a continuum as well as increasing exposure throughout medical education. Discussion Whilst generalism is consistently positioned as valuable, less clarity exists about how best to operationalise this in medical education. Fundamental ideological and structural changes within teaching curricula and assessment, are necessary to improve generalist learning and to promote sustainable practice. Medical education needs careful, considered planning to ensure workforce expertise is meeting population needs

The Effect of 12-Weeks Recreational Football (Soccer) for Health Intervention on Functional Movement in Older Adults

There is growing evidence that recreational football offers health benefits for older adults and an important pathway for physical activity for older adult groups. Despite anecdotal evidence that recreational football is beneficial for older adults, no empirical data are available to support this assertion. This study addressed this issue and examined the effects of a 12‐week recreational football intervention on the functional fitness of older adults. Using a pre–post case–control design, thirteen males, aged 61–73 years (mean age ± SD = 66 ± 4 years) undertook a twice‐weekly, 12‐week recreational football for health intervention, and were matched with a control group, comprising thirteen males, aged 62–78 years (mean age ± SD = 66 ± 4 years) who maintained their typical exercise habits during the intervention period. Pre‐ and postintervention, participants underwent assessment of functional fitness, using the Rikli and Jones functional fitness battery as well as an assessment of body fatness, via bioelectrical impedance analysis and dominant handgrip strength using handgrip dynamometry. Results from a series of 2 (pre–post) X 2 (intervention vs. control) repeated‐measures ANOVAs indicate significant pre–post X group interactions for the 30‐second chair stand (p = 0.038, Pƞ2 = 0.168), 8‐foot timed up and go (p = 0.001, Pƞ2 = 0.577) and 6 min walk test (p = 0.036, Pƞ2 = 0.171). In all cases, performance improved significantly after the intervention for the football intervention group but not the control group. There were no significant differences in the 30 s arm curl test or dominant handgrip strength (p > 0.05). There was a non‐significant trend (p = 0.07, Pƞ2 = 0.127) towards a pre–post X group interaction for body fatness, showing a decreased percent body fat for the intervention group over the control group. The results of the present study demonstrate the utility of recreational football as a physical activity intervention in older adults to improve functional movement