Exploring the Student Experience of the Final Year of a Professionally-Oriented Undergraduate Degree in Education Studies

Within Higher Education there is growing expectations that graduates will enjoy smooth transitions into practice or further study and thus it is important to understand how higher education students’ experiences in university should be best organised and integrated to realise these purposes. This qualitative research study investigated the impact of the curriculum design of the final year on student experience, engagement and progression routes post-graduation in a new four year professionally-orientated degree for students in a BSc in Education Studies in an Irish education institution. This study involved 26 lecturers and 25 recent graduates from the programme. Students were required to undertake a final year (capstone project) dissertation and an internship (involving the development of an ePortfolio to demonstrate and reflect on their journey of learning and to make connections with learning across the final year). Data was collected by means of an online student survey, followed by a focus group interview with self-selecting student participants as well a focus group interview with the programme development team. The focus of this work is on presenting the findings in terms of student experience of the balance between the internship and the dissertation as a preparation for their professional pathway; it also explores the lecturer experience as curriculum designers and facilitators. The study is underpinned by an exploration of enquiry-based learning, curriculum design, the capstone project and education studies as a discipline. Ultimately the intention of the research team is to improve the curriculum design process and outcome for the programme, and to contribute to the knowledge base on the highlights and challenges of designing and delivering professionally-orientated degrees into the future

The Student Experience of Final Year in an Undergraduate Degree Programme in Education Studies.

This case study explores the student experience of the final year of a four-year undergraduate degree in ‘Education Studies’, with a focus on the perceived impact of curriculum design of the programme. The context is an Irish college of education, and the programme structure has been designed to allow for flexibility to accommodate varying student interests and professional pathways. As the first full iteration of the programme came to a close, it was considered an opportune time to ascertain if the programme was meeting its curriculum design objectives in terms of preparation for the chosen professional pathway post-graduation from both the student and staff perspective. Literature explored included learning ecologies, work-based learning, and the final year experience. Data was collected through a student survey, individual interviews with self-selecting students, and a focus-group interview with the programme development team. Findings suggest that students could clearly identify the development of skills, knowledge and competencies for the workplace through an internship; also highlighted was value in undertaking a dissertation for researching a topic of personal interest, with it noted as a challenging, intense experience. Having appropriate levels and different types of support for students facing the challenges in final year was a significant outcome. A model emerged for final year support in three contexts: pedagogic, workplace and research, and we argue that this is a main research contribution that this study makes to educational research. A discussion of implications for curriculum development in ‘Education Studies’ highlights the need for ‘cohesion’ workshops to be integrated to final year to synthesise student learning, embedding a formalised support structure in order for students to have a greater understanding of choices available to them post-graduation, and introducing a scaffolded approach to ePortfolio development to encourage innovation

Supervised pulmonary hypertension exercise rehabilitation (SPHERe):Study protocol for a multi-centre randomised controlled trial

Background Supervised cardio-pulmonary rehabilitation may be safe and beneficial for people with pulmonary hypertension (PH) in groups 1 (pulmonary arterial hypertension) and 4 (chronic thromboembolic disease), particularly as a hospital in-patient. It has not been tested in the most common PH groups; 2 (left heart disease), 3 (lung disease), or 5 (other disorders). Further it has not been evaluated in the UK National Health Service (NHS) out-patient setting, or with long-term follow-up. The aim of this randomised controlled trial (RCT) is to test the clinical and cost-effectiveness of a supervised exercise rehabilitation intervention with psychosocial support compared to best practice usual care for people with PH in the community/outpatient setting. Methods This multi-centre, pragmatic, two-arm RCT with embedded process evaluation aims to recruit 352 clinically stable adults with PH (groups 1–5) and WHO functional class II-IV. Participants will be randomised to either the Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) intervention or control. The SPHERe intervention consists of 1) individual assessment and familiarisation sessions; 2) 8-week, twice-weekly, supervised out-patient exercise training; 3) psychosocial/motivational support and education; 4) guided home exercise plan. The control intervention consists of best practice usual care with a single one-to-one practitioner appointment, and general advice on physical activity. Outcomes will be measured at baseline, 4 months (post-intervention) and 12 months by researchers blinded to treatment allocation. The primary outcome is the incremental shuttle walk test at 4 months. Secondary outcomes include health-related quality of life (HRQoL), time to clinical worsening and health and social care use. A purposive sample of participants (n = 20 intervention and n = 20 control) and practitioners (n = 20) will be interviewed to explore experiences of the trial, outcomes and interventions. Discussion The SPHERe study is the first multi-centre clinical RCT to assess the clinical and cost effectiveness of a supervised exercise rehabilitation intervention compared to usual care, delivered in the UK NHS, for people in all PH groups. Results will inform clinicians and commissioners as to whether or not supervised exercise rehabilitation is effective and should be routinely provided for people with PH

Mapping the drivers of parasitic weed abundance at a national scale : a new approach applied to Striga asiatica in the mid‐west of Madagascar

The parasitic weed genus Striga causes huge losses to crop production in sub‐Saharan Africa, estimated to be in excess of $7 billion per year. There is a paucity of reliable distribution data for Striga ; however, such data are urgently needed to understand current drivers, better target control efforts, as well as to predict future risks. To address this, we developed a methodology to enable rapid, large‐scale monitoring of Striga populations. We used this approach to uncover the factors that currently drive the abundance and distribution of Striga asiatica in Madagascar. Two long‐distance transects were established across the middle‐west region of Madagascar in which S. asiatica abundance in fields adjacent to the road was estimated. Management, crop structure and soil data were also collected. Analysis of the data suggests that crop variety, companion crop and previous crop were correlated with Striga density. A positive relationship between within‐field Striga density and the density of the nearest neighbouring fields indicates that spatial configuration and connectivity of suitable habitats is also important in determining Striga spread. Our results demonstrate that we are able to capture distribution and management data for Striga density at a landscape scale and use this to understand the ecological and agronomic drivers of abundance. The importance of crop varieties and cropping patterns is significant, as these are key socio‐economic elements of Malagasy cropping practices. Therefore, they have the potential to be promoted as readily available control options, rather than novel technologies requiring introduction

Oxytocin and Vasopressin Are Dysregulated in Williams Syndrome, a Genetic Disorder Affecting Social Behavior

The molecular and neural mechanisms regulating human social-emotional behaviors are fundamentally important but largely unknown; unraveling these requires a genetic systems neuroscience analysis of human models. Williams Syndrome (WS), a condition caused by deletion of ∼28 genes, is associated with a gregarious personality, strong drive to approach strangers, difficult peer interactions, and attraction to music. WS provides a unique opportunity to identify endogenous human gene-behavior mechanisms. Social neuropeptides including oxytocin (OT) and arginine vasopressin (AVP) regulate reproductive and social behaviors in mammals, and we reasoned that these might mediate the features of WS. Here we established blood levels of OT and AVP in WS and controls at baseline, and at multiple timepoints following a positive emotional intervention (music), and a negative physical stressor (cold). We also related these levels to standardized indices of social behavior. Results revealed significantly higher median levels of OT in WS versus controls at baseline, with a less marked increase in AVP. Further, in WS, OT and AVP increased in response to music and to cold, with greater variability and an amplified peak release compared to controls. In WS, baseline OT but not AVP, was correlated positively with approach, but negatively with adaptive social behaviors. These results indicate that WS deleted genes perturb hypothalamic-pituitary release not only of OT but also of AVP, implicating more complex neuropeptide circuitry for WS features and providing evidence for their roles in endogenous regulation of human social behavior. The data suggest a possible biological basis for amygdalar involvement, for increased anxiety, and for the paradox of increased approach but poor social relationships in WS. They also offer insight for translating genetic and neuroendocrine knowledge into treatments for disorders of social behavior

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Estimated stroke risk, yield, and number needed to screen for atrial fibrillation detected through single time screening: a multicountry patient-level meta-analysis of 141,220 screened individuals

BackgroundThe precise age distribution and calculated stroke risk of screen-detected atrial fibrillation (AF) is not known. Therefore, it is not possible to determine the number needed to screen (NNS) to identify one treatable new AF case (NNS-Rx) (i.e., Class-1 oral anticoagulation [OAC] treatment recommendation) in each age stratum. If the NNS-Rx is known for each age stratum, precise cost-effectiveness and sensitivity simulations can be performed based on the age distribution of the population/region to be screened. Such calculations are required by national authorities and organisations responsible for health system budgets to determine the best age cutoffs for screening programs and decide whether programs of screening should be funded. Therefore, we aimed to determine the exact yield and calculated stroke-risk profile of screen-detected AF and NNS-Rx in 5-year age strata.Methods and findingsA systematic review of Medline, Pubmed, and Embase was performed (January 2007 to February 2018), and AF-SCREEN international collaboration members were contacted to identify additional studies. Twenty-four eligible studies were identified that performed a single time point screen for AF in a general ambulant population, including people ≥65 years. Authors from eligible studies were invited to collaborate and share patient-level data. Statistical analysis was performed using random effects logistic regression for AF detection rate, and Poisson regression modelling for CHA2DS2-VASc scores. Nineteen studies (14 countries from a mix of low- to middle- and high-income countries) collaborated, with 141,220 participants screened and 1,539 new AF cases. Pooled yield of screening was greater in males across all age strata. The age/sex-adjusted detection rate for screen-detected AF in ≥65-year-olds was 1.44% (95% CI, 1.13%–1.82%) and 0.41% (95% CI, 0.31%–0.53%) for <65-year-olds. New AF detection rate increased progressively with age from 0.34% (<60 years) to 2.73% (≥85 years). Neither the choice of screening methodology or device, the geographical region, nor the screening setting influenced the detection rate of AF. Mean CHA2DS2-VASc scores (n = 1,369) increased with age from 1.1 (<60 years) to 3.9 (≥85 years); 72% of ≥65 years had ≥1 additional stroke risk factor other than age/sex. All new AF ≥75 years and 66% between 65 and 74 years had a Class-1 OAC recommendation. The NNS-Rx is 83 for ≥65 years, 926 for 60–64 years; and 1,089 for <60 years. The main limitation of this study is there are insufficient data on sociodemographic variables of the populations and possible ascertainment biases to explain the variance in the samples.ConclusionsPeople with screen-detected AF are at elevated calculated stroke risk: above age 65, the majority have a Class-1 OAC recommendation for stroke prevention, and >70% have ≥1 additional stroke risk factor other than age/sex. Our data, based on the largest number of screen-detected AF collected to date, show the precise relationship between yield and estimated stroke risk profile with age, and strong dependence for NNS-RX on the age distribution of the population to be screened: essential information for precise cost-effectiveness calculations

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]