Healthy University – University of Central Lancashire

In 1995, the University of Central Lancashire became one of the first few universities to establish a Healthy University initiative – now one of the longest-running initiatives of its kind worldwide. This case study details the context, provides an overview of the initiative and uses food as a focus for illustrating how the whole system Healthy University approach has been developed and implemented in practice. It also introduces the UK Healthy Universities Network

National research and development project on healthy universities: final report

This report presents the findings of a National Research and Development Project, undertaken by the Healthy Settings Development Unit at the University of Central Lancashire and funded by the Higher Education Academy Health Sciences and Practice Subject Centre and the Department of Health. The aim of the project was to scope and report on the potential for a national programme on Healthy Universities that could contribute to health, well-being and sustainable development. The project comprised four strands: - Literature Review: A rapid review of relevant academic and policy-related literature conducted in order to clarify theory, scope practice and distil key contextual issues. - HEI-level Research: Comprising an overview audit and follow-up mapping and consultative research, this strand of the project provided an overview of Healthy University activity across English HEIs, generated in-depth data from a purposive sample of universities and explored perspectives on the potential development of a national programme on Healthy Universities. - National-Level Stakeholder Research: Using semi-structured interviews with nine key national stakeholder organisations, this strand of the project mapped current health-related roles and responsibilities and explored views regarding the potential development of a national programme on Healthy Universities. - Joint Action Planning and Reporting: In addition to reporting interim findings at relevant conferences and events, an interactive workshop was held with members of the English National Healthy Universities Network to present findings, validate data, inform the action planning process and secure further buy-in. The project highlighted that higher education offers enormous potential to impact positively on the health and well-being of students, staff and the wider community through education, research, knowledge exchange and institutional practice. It also suggested that investment for health within the sector will further contribute to core agendas such as staff and student recruitment, experience and retention; and institutional and societal productivity and sustainability. The research revealed the richness of activity taking place within HEIs and evidenced a rapid increase in interest in the Healthy University approach, pointing to a growing appreciation of the need for a comprehensive whole system approach that can map and understand interrelationships, interactions and synergies within higher education settings – with regard to different groups of the population, different components of the system and different health issues. There is a clear challenge involved in introducing and integrating ‘health’ within a sector that does not have this as its central aim, is characterised by ‘initiative overload’, is experiencing resource constraints and comprises fiercely autonomous institutions. However, there is also a widening recognition that such a system-based approach has significant added value – offering the potential to address health in a coherent and joined-up way and to forge connections to both health-related targets and core drivers within higher education. The report concludes that there is clear demand for national-level stakeholder organisations to demonstrate leadership through championing and resourcing a Healthy Universities Programme that not only adds value within the higher education sector, but also helps to build consistency of approach across the entire spectrum of education. It issues a number of recommendations with a view to responding to the findings and moving forward

Healthy Universities: Concept, Model and Framework for Applying the Healthy Settings Approach within Higher Education in England

As part of a Department of Health funded project, the University of Central Lancashire (UCLan) – working with Manchester Metropolitan University – was commissioned by the Royal Society for Public Health (RSPH), to: - articulate a model for Healthy Universities whereby the healthy settings approach is applied within the higher education sector - produce recommendations for the development and operationalisation of a National Healthy Universities Framework for England - to ensure effective co-ordination of initiatives and propose next steps for progressing the Healthy Universities agenda. In fulfilment of these objectives, this report provides a background to Healthy Universities, outlines the project implementation process, presents a model, discusses the key dimensions for consideration in formulating a framework, and makes recommendations for taking things forward

The identification of markers of macrophage differentiation in PMA-stimulated THP-1 Cells and monocyte-derived macrophages

Differentiated macrophages are the resident tissue phagocytes and sentinel cells of the innate immune response. The phenotype of mature tissue macrophages represents the composite of environmental and differentiation-dependent imprinting. Phorbol-12-myristate-13-acetate (PMA) and 1,25-dihydroxyvitamin D3 (VD3) are stimuli commonly used to induce macrophage differentiation in monocytic cell lines but the extent of differentiation in comparison to primary tissue macrophages is unclear. We have compared the phenotype of the promonocytic THP-1 cell line after various protocols of differentiation utilising VD3 and PMA in comparison to primary human monocytes or monocyte-derived macrophages (MDM). Both stimuli induced changes in cell morphology indicative of differentiation but neither showed differentiation comparable to MDM. In contrast, PMA treatment followed by 5 days resting in culture without PMA (PMAr) increased cytoplasmic to nuclear ratio, increased mitochondrial and lysosomal numbers and altered differentiation-dependent cell surface markers in a pattern similar to MDM. Moreover, PMAr cells showed relative resistance to apoptotic stimuli and maintained levels of the differentiation-dependent anti-apoptotic protein Mcl-1 similar to MDM. PMAr cells retained a high phagocytic capacity for latex beads, and expressed a cytokine profile that resembled MDM in response to TLR ligands, in particular with marked TLR2 responses. Moreover, both MDM and PMAr retained marked plasticity to stimulus-directed polarization. These findings suggest a modified PMA differentiation protocol can enhance macrophage differentiation of THP-1 cells and identify increased numbers of mitochondria and lysosomes, resistance to apoptosis and the potency of TLR2 responses as important discriminators of the level of macrophage differentiation for transformed cells

Ex vivo cytokine mRNA levels correlate with changing clinical status of ethiopian TB patients and their contacts over time.

There is an increasing body of evidence which suggests that IL-4 plays a role in the pathogenesis of TB, but a general consensus on its role remains elusive. We have previously published data from a cohort of Ethiopian TB patients, their contacts, and community controls suggesting that enhanced IL-4 production is associated with infection with M. tuberculosis, rather than overt disease and that long-term protection in infected community controls is associated with co-production of the IL-4 antagonist IL-4d2, alongside elevated IL-4. Here, for the first time, we compare data on expression of IFN-gamma, IL-4 and IL-4delta2 over time in TB patients and their household contacts. During the follow-up period, the TB patients completed therapy and ceased to display TB-like symptoms. This correlated with a decrease in the relative amount of IL-4 expressed. Over the same period, the clinical status of some of their contacts also changed, with a number developing TB-like symptoms or clinically apparent TB. IL-4 expression was disproportionately increased in this group. The findings support the hypothesis that elevated IL-4 production is generally associated with infection, but that TB disease is associated with a relatively increased expression of IL-4 compared to IFN-gamma and IL-4delta2. However, the data also suggest that there are no clear-cut differences between groups: the immune response over time appears to include changes in the expression of IFN-gamma, IL-4 and IL-4delta2, and it is the relative, not absolute levels of cytokine expression that are characteristic of clinical status

The UK Healthy Universities Self Review Tool: Whole System Impact

Over recent years, there has been growing interest in Healthy Universities, evidenced by an increased number of national networks and the participation of 375 participants from over 30 countries in the 2015 International Conference on Health Promoting Universities and Colleges, which also saw the launch of the Okanagan Charter. This paper reports on research exploring the use and impact of the UK Healthy Universities Network’s self review tool, specifically examining whether this has supported universities to understand and embed a whole system approach. The research study comprised two stages, the first using an online questionnaire and the second using focus groups. The findings revealed a wide range of perspectives under five overarching themes: motivations; process; outcomes/benefits; challenges/suggested improvements; and future use. In summary, the self review tool was extremely valuable and, when engaged with fully, offered significant benefits to universities seeking to improve the health and wellbeing of their communities. These benefits were felt by institutions at different stages in the journey and spanned outcome and process dimensions: not only did the tool offer an engaging and user-friendly means of undertaking internal benchmarking, generating an easy-to-understand report summarizing strengths and weaknesses; it also proved useful in building understanding of the whole system Healthy Universities approach and served as a catalyst to effective cross-university and cross-sectoral partnership working. Additionally, areas for potential enhancement were identified, offering opportunities to increase the tool’s utility further whilst engaging actively in the development of a global movement for Healthy Universitie

Added value of IP-10 as a read-out of <em>Mycobacterium tuberculosis</em>:Specific immunity in young children

We have explored the added value of interferon-γ (IFNγ)–inducible protein 10 as a read-out of Mycobacterium tuberculosis–specific immunity in young Indian children, where the sensitivity of the IFNγ release assays for tuberculosis is poor. Reduced frequency of indeterminate results and an increased sensitivity for tuberculosis suggest a potential for fewer missed cases with a combined IFNγ/inducible protein 10 read-out in a 4th generation IFNγ release assays

Identification of T cell stimulatory epitopes from the 18 kDa protein of Mycobacterium leprae

We have used different mouse strains to examine in vivo and in vitro responses to the 18 kDa protein of Mycobacterium leprae, which appears to be strongly immunogenic in both mice and humans. B and T cell stimulatory epitopes recognised by different strains of mice have been mapped using overlapping peptides that span the entire 18 kDa protein. Previous work established that Immunization of mice with the 18 kDa protein results in specific antibody production to common B cell epitopes and immunization of mice with peptides containing these B cell epitopes resulted in the induction of specific IgG to only a limited subset of epitopes in each strain. Now we report that T cells purified from mice immunized with peptides that stimulate antibody production, proliferate in vitro when rechallenged. The proliferating T cells produce levels of IL-2 and IFN-γ, that indicate antigen-specific T helper type 1 cells are present in significant numbers. Thus, a comparison of in vivo and in vitro data suggests that T cells bearing the phenotype associated with potentially protective cell-mediated responses can be primed in vivo by epitopes on small peptides. Since T cells from both strains of mice are capable of responding to the immunogenic synthetic peptides in vitro, but give different responses to the same peptides in vivo, factors other than epltope structure appear to influence T cell subset activation. This may have important implications for diseases such as leprosy where a polarized T cell response appears to develop and for the development of synthetic subunit vaccine