Shaping the future for primary care education and training project. Best practise in education and training strategies for integrated health and social care: development of a benchmarking tool

Collaboration and partnership working between Higher Education and the NHS is an essential requirement for effective delivery of care (Universities UK 2003). The North West Universities Association (NWUA) and the North West Development Agency (NWDA) are two organisations at the forefront of creating such alliances. The research project, Shaping the Future for Primary Care Education and Training Project is a collaborative partnership between both these organisations and seven North West Higher Education Institutions. In addition, the project brings together for the first time all the key partners in the health, social care and education sectors who are involved in supporting the delivery of integrated health and social care in the North West Region

A review of the tolerability and safety of levocabastine eye drops and nasal spray. Implications for patient management

Levocabastine is a highly potent and selective H1-receptor antagonist specifically developed for topical administration by ocular and nasal routes. The clinical effects of levocabastine occur rapidly and are predominantly due to local antihistaminic effects at the site of application. Clinically, levocabastine is well tolerated with an adverse effect profile comparable with that of sodium cromoglycate and placebo. As might be expected from the route of drug administration, local irritation is the most frequent adverse event seen with levocabastine eye drops and nasal spray with an incidence comparable with that in placebo-treated controls. Intranasal application of levocabastine has been shown to have no adverse effect on ciliary activity both in vitro and in vivo, while ocular administration has not been shown to have any significant or consistent adverse effect in both animal and human studies. At therapeutic doses, levocabastine appears to be devoid of significant systemic activity producing no apparent effects on cardiovascular, psychomotor and cognitive function. Since levocabastine undergoes little hepatic metabolism, and only low plasma levels of the drug are attained following topical administration, drug interactions are unlikely

Social prescribing : the whys, wherefores and implications for nurses & prescribers.

This article discusses ‘social prescribing’ as a non-medical approach for nurse prescribers that can promote health and wellbeing within a personalised care context as part of the NHS Long Term Plan (DHS 2019). The concept of social prescribing and its origins will be described alongside common interventions and services. This article concludes with an exploration of how social prescribing can be used to compliment nurse prescribing to support personalised care

Prebiotics: a potential treatment strategy for the chemotherapy-damaged gut?

Abstract Mucositis, characterized by ulcerative lesions along the alimentary tract, is a common consequence of many chemotherapy regimens. Chemotherapy negatively disrupts the intestinal microbiota, resulting in increased numbers of potentially pathogenic bacteria, such as Clostridia and Enterobacteriaceae, and decreased numbers of "beneficial" bacteria, such as Lactobacilli and Bifidobacteria. Agents capable of restoring homeostasis in the bowel microbiota could therefore be applicable to mucositis. Prebiotics are indigestible compounds, commonly oligosaccharides, which seek to reverse chemotherapy-induced intestinal dysbiosis through selective colonization of the intestinal microbiota by probiotic bacteria. In addition, evidence is emerging that certain prebiotics contribute to nutrient digestibility and absorption, modulate intestinal barrier function through effects on mucin expression, and also modify mucosal immune responses, possibly via inflammasome-mediated processes. This review examines the known mechanisms of prebiotic action and explores their potential to reduce the severity of chemotherapy-induced mucositis in the intestine.Hanru Wang, Mark S Geier and Gordon S Howart

Professional competence frameworks and personalisation: their role in employability

In this roundtable, we will question the role and function of personalisation and/or professional competence frameworks in supporting and guiding the development of student employability. Of particular interest will be what this means when it comes to the dominant(?) approach to work in this area within business schools and the related outcomes. The roundtable is formed around the following organising questions: Question 1: To what extent is the dominant approach to employability within business schools the acquisition of knowledge and skills rather than a focus on professional behaviours. Question 2: What contributes to successful personalisation of the student experience and do, or how may, professional body competence frameworks contribute to this? Question 3: What insights can we develop and share regarding the links between employability (education) and the personalisation of higher education and what might (a) new approach(es) look like

Development of an Integrated Governance Strategy for the Voluntary and Community Sector

This report on governance provides a framework for thinking about how policy makers, funders,regulators and advisers can all work with Board members and staff to enhance the effectiveness of nonprofit organisations. It was commissioned by the Active Community Unit (ACU) of the Home Office, in parallel with other reviews designed to improve the capacity of the voluntary and community sector, at a time when the sector plays an increasingly important role in the delivery of services using public funds. That role has recently been investigated in two Government reports, the Cross Cutting Review carried out by the Treasury, and the Strategy Unit review of charities and nonprofits. Our report proposes actions of three types: some that can be taken immediately, some that require further discussion with key interests, and some integration with the other ACU reviews. Taken together they provide the starting point for an evolving strategy to improve governance across the sector. We recommend ACU chairs a group charged with the responsibility for planning and implementing this. Our focus is on governance as 'the systems and processes concerned with ensuring the overall direction, supervision and accountability of an organisation'. This is often taken to mean the way that a Board, management committee or other governing body steers the overall development of an organisation, where day-to-day management is in the hands of staff or volunteers. Sometimes, of course, the committee and volunteers are the same. They – like all governing bodies – have to balance the interests of the organisation and those they are trying to serve, while being conscious of financial and legal responsibilities, and the requirements of funders and other supporters

FUSE Observations of a Full Orbit of Hercules X-1: Signatures of Disk, Star, and Wind

We observed an entire 1.7 day orbit of the X-ray binary Hercules X-1 with the Far Ultraviolet Spectroscopic Explorer (FUSE). Changes in the O VI 1032,1037 line profiles through eclipse ingress and egress indicate a Keplerian accretion disk spinning prograde with the orbit. These observations may show the first double-peaked accretion disk line profile to be seen in the Hercules X-1 system. Doppler tomograms of the emission lines show a bright spot offset from the Roche lobe of the companion star HZ Her, but no obvious signs of the accretion disk. Simulations show that the bright spot is too far offset from the Roche lobe to result from uneven X-ray heating of its surface. The absence of disk signatures in the tomogram can be reproduced in simulations which include absorption from a stellar wind. We attempt to diagnose the state of the emitting gas from the C III 977, C III 1175, and N III 991 emission lines. The latter may be enhanced through Bowen fluorescence.Comment: Accepted for publication in The Astrophysical Journa

Experience of the impact of physician associates on ­postgraduate medical training: A mixed methods ­exploratory study

The introduction of new professional roles to the multidisciplinary team has been heralded as a way to facilitate medical education in the face of increasing service pressures. However, concerns have been raised that the training of new healthcare professionals will dilute the availability of learning opportunities, thereby detracting from postgraduate medical education. As part of a mixed methods exploratory study, the experienced impact of newly qualified physician associates on medical training was explored. Within 6 months of newly qualified physician associates being introduced, half of junior doctors reported no overall impact on their training and a third felt that their training was enhanced by the presence of physician associates. A minority of trainees experienced dilution of training opportunities. The findings support the notion that new healthcare professionals do not detract from medical training and suggest that roles such as the physician associate have potential to enhance postgraduate medical education

‘What can you do then?’ Integrating new roles into healthcare teams: Regional experience with physician associates

In the context of NHS workforce shortages, providers are increasingly looking to new models of care, diversifying the workforce and introducing new roles such as physician associates (PAs) into clinical teams. The current study used qualitative methods to investigate how PAs are integrated into a workforce in a region largely unfamiliar with the profession. We conducted an observational study examining factors that facilitated and challenged PA integration. Findings suggest that the factors influencing PA integration relate to attributes of the individual, interpersonal relationships and organisational elements. From these, five key considerations have been derived which may aid organisations when planning to integrate new roles into the clinical workforce: prior to introducing PAs organisations should consider how to fully inform current staff about the PA profession; how to define the role of the PA within teams including clinical supervision arrangements; investment in educational and career development support for PAs; communication of remuneration to existing staff and conveying an organisational vision of PAs within the future workforce. Through consideration of these areas, organisations can facilitate role integration, maximising the potential of the workforce to contribute to sustainable healthcare provision