Breast and prostate cancer survivor responses to group exercise and supportive group psychotherapy

This study qualitatively examined an 8 week group exercise and counseling intervention for breast and prostate cancer survivors. Groups exercised 3 days per week, 50 minutes per session, performing moderate intensity aerobic and resistance training. Groups also underwent 90 minute supportive group psychotherapy sessions once per week. Survivors discussed their experiences in focus groups post intervention. Transcripts were analyzed using interpretative phenomenological analysis. Survivors described how exercise facilitated counseling by creating mutual aid and trust, and counseling helped participants with self-identity, sexuality, and returning to normalcy. When possible, counselors and fitness professionals should create partnerships to optimally support cancer survivors

From ABC’s to 3P’s (and a couple of T’s): Exploring Factors Affecting Student Learning in Higher Education and the Need for an Updated Educational Framework

Higher education is a challenging landscape to investigate, as it encompasses a diverse range of student backgrounds and requires a focus on developing metacognitive thinking skills, creating effective learning environments, and promoting student engagement and motivation. Over the years, various frameworks have been developed to describe the learning experiences and processes of higher education students. However, the rapidly changing nature of the 21st century demands that educational researchers and universities re-evaluate the established teaching and learning frameworks. This has become especially clear during the COVID-19 pandemic, where the sudden shift to online learning has highlighted the need for flexible and adaptable approaches to education. As we move forward, it is essential to continue to examine and develop effective frameworks that can support students in navigating the challenges of higher education and beyond. Three of the studies presented as part of this PhD have been published as journal papers or book chapters, while the other two are under review. In addition to the main chapter publications, several other publications have been submitted to various international journals evaluating current frameworks and providing suggestions for alternative interventions. This PhD aims to explore several factors that influence student learning promoting a revision to the well-established educational framework of Biggs’ (1993) 3P model. Despite its age this model continues to be widely used in higher education, emphasising the importance of three factors: presage, process, and product when considering the factors that affect student outcomes. The aim and the rationale of this PhD, along with a broader discussion on the widely used Higher Education frameworks are presented in the introduction, while an adapted model (3P2T) is proposed in the discussion. Each of the studies presented is related to either one or a combination of Biggs’ (1993) three factors affecting student outcomes. Specifically, study one explores the impact of prior learning and knowledge on student academic performance. This study explored the effects of prior knowledge on first-year Psychology students' academic achievements through ordinal regressions and correlations. In order to explore the role of digital learning tools in Higher Education and their potential benefits during disruptive events for learning (i.e., industrial strikes), study two compares students' Virtual Learning Environment (VLE) behaviour across three consecutive first-year undergraduate Psychology cohorts, in which one year was impacted by industrial strikes. Next, study three, empirically explores the relationship between students' learning approaches, metacognition, and academic performance using longitudinally collected data. Results suggest that a further investigation of these and other factors affecting student outcomes should be explored. Study four does exactly this and presents a new questionnaire, adapting items from the widely used Motivated Strategies for Learning Questionnaire (MSLQ; Pintrich et al., 1991) including three new key themes of course utility, procrastination, and use of diverse sources and test anxiety. Finally, the last study, study five, qualitatively explores the multiple transitions that students undergo as they move from secondary to tertiary education (University), including changes in education, student socialisation, and emotions. Students arrive with expectations about their University experience, based on their understanding of what it means to study at this level, and the interviews explore how these expectations manifest and change throughout their degree. The study used thematic analysis to identify five key themes that shape students' experiences: prior experience, adjustment to university, staff relationships, the experience of studying, and future plans. Overall, the five studies employed various qualitative, quantitative, and analytical research methods in order to investigate how current Higher Education changes may affect student learning experience across different stages over their degree. The main findings of this research project argue that the need of an updated version of well-established educational frameworks (i.e., Biggs’ 1993 3P model) is necessary. Such necessity is driven by the changes in University learning processes, student expectations and engagement, use of learning technologies, and the demographic pool now entering Higher Education. The research findings suggest that educational policymakers and University teachers should consider factors such as digital learning tools, diverse populations, and new teaching and learning methodologies to ensure the continuation of educational framework relevance and usefulness. Applying this consideration will guide the design and delivery of Higher Education, allowing teachers to tailor their approaches to meet the needs of ever growing and diversifying range of students

A critique of blended learning: Examples from an undergraduate psychology program

The adoption of technology to a University curriculum is challenging and requires a complex blend with pedagogical components. The aim of this study is to examine how digital learning tools could enhance first year modules supporting blended learning approaches. Two psychology modules are used as examples to discuss two different blended approaches and study student engagement with learning process by exploring their performance on online activities under the perspective of module design, students’ engagement with formative and summative assessments, and digital literacy. The digital learning tools that supported the two blended learning approaches were wikis, blogs, online tests. This investigation was conducted for two subsequent years in a UK Psychology School in which a large number of students were enrolled. The total number of students who participated in this investigation for the 2016-2017 academic year was 407 and for the 2017-2018 academic year was 405. In the first example, an academic performance comparison was conducted between the students who have been engaged with online formative activities and those students who have attended the face-to-face classes only in a transferable skills module. In the second example, a compulsory online continuous assessment process was followed to support a first-year psychology module aiming to enhance student learning on biology topics. This article discusses how students might engage with online formative and summative activities in association with their performance and how different assessment types alongside with the use of different digital learning tools might enhance blended learning environments. Findings of this study suggest that teachers should connect formative with summative assessments in order to increase student performance and they should consider blended learning approaches under the perspective of pedagogical principles and continuous assessment in order to increase student engagement with their learning process

A Longitudinal Examination of Student Approaches to Learning and Metacognition

Student Approaches to Learning (SAL) mainly consists of two contradictory approaches (surface and deep learning) to learning that have been extensively studied in educational research. Metacognition, which refers to the process of thinking about one’s thinking, has been shown to play a crucial role in helping students shift from a surface to a deep approach to learning. The current study collected data using two questionnaires (RSPQ-2F&amp; MAI) from 1329 students. Both metacognition and learning approaches showed medium correlations and an effect of the year of study. A crossed-lagged model shows no effect of deep learning on metacognitive knowledge or regulation, although this does increase significantly over time. Overall, the study’s findings suggest a complex yet clear relationship between student learning approaches and their final grade outcomes. Students will lean towards more surface learning as their (perceived) workload increases and assessments become more challenging. These findings suggest that teachers and policy makers should seek ways to increase deep learning methods, possibly using metacognitive skills training.</jats:p

The influence of motor competence on adolescent identity health: A mixed method study

Our identity develops with age, and many impacting factors will determine whether it is healthy or unhealthy. A particularly fragile phase of identity development occurs during adolescence when level of motor competence may be influential, yet is rarely considered. Purpose: The purpose of this study was to examine male and female adolescent’s perceptions towards their motor competence and identity development. In-depth information was also collected to understand what factors are important towards identity development during adolescence. Method: An explanatory sequential mixed methods study was used to examine the extent motor competence influenced the health of an adolescent’s identity. A sample of 160 adolescents (male n = 103, female n = 57, Mage = 14.45 SD = .75) completed the Adolescent Motor Competence Questionnaire (AMCQ) and the Assessment of Identity Development in Adolescence (AIDA). The AMCQ scores were used to group the participants into high (HMC = \u3e 83) and low (LMC = \u3c 83) motor competence. Results: More females had less-healthy identities than males and those with LMC had less-healthy identities than those with HMC. Subsamples of 17 participants were interviewed in order to explain these results. The most at risk group, females with LMC, identified negative peer comparisons, poor social support and higher stress levels to achieve academic performance as key challenges. Conclusions. Well-designed support services for those with LMC, especially for the females should incorporate activities to develop individual competency and close friendships

The Big Five, Learning Goals, Exam Preparedness, and Preference for Flipped Classroom Teaching: Evidence from a Large Psychology Undergraduate Cohort

Previous research has found that the flipped classroom (i.e., learning prior to the lecture, and using the lecture time for consolidating knowledge) increases students’ deep learning, and has an association with improved grades. However, not all students benefit equally from flipping the classroom, and there may be important individual differences that influence preference for different teaching styles. In the present study, undergraduate Psychology students ( n = 200) answered questions about exam preparedness, learning goals, preference for the traditional or flipped classroom, and the Big Five of personality. We found that preference for the flipped classroom had a significant, positive association with agreeableness and the mastery goal. Preference for the traditional lecture was predicted by beliefs about exam preparedness. The results are discussed with a reference to the Big Five paradigm in the context of learning and teaching. </jats:p

Basic science232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function

Background: Cardiovascular disease is a major comorbidity of rheumatoid arthritis (RA) and a leading cause of death. Chronic systemic inflammation involving tumour necrosis factor alpha (TNF) could contribute to endothelial activation and atherogenesis. A number of anti-TNF therapies are in current use for the treatment of RA, including certolizumab pegol (CZP), (Cimzia ®; UCB, Belgium). Anti-TNF therapy has been associated with reduced clinical cardiovascular disease risk and ameliorated vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function are largely unknown. Our aim was to investigate the mechanisms underpinning CZP effects on TNF-activated human endothelial cells. Methods: Human aortic endothelial cells (HAoECs) were cultured in vitro and exposed to a) TNF alone, b) TNF plus CZP, or c) neither agent. Microarray analysis was used to examine the transcriptional profile of cells treated for 6 hrs and quantitative polymerase chain reaction (qPCR) analysed gene expression at 1, 3, 6 and 24 hrs. NF-κB localization and IκB degradation were investigated using immunocytochemistry, high content analysis and western blotting. Flow cytometry was conducted to detect microparticle release from HAoECs. Results: Transcriptional profiling revealed that while TNF alone had strong effects on endothelial gene expression, TNF and CZP in combination produced a global gene expression pattern similar to untreated control. The two most highly up-regulated genes in response to TNF treatment were adhesion molecules E-selectin and VCAM-1 (q 0.2 compared to control; p > 0.05 compared to TNF alone). The NF-κB pathway was confirmed as a downstream target of TNF-induced HAoEC activation, via nuclear translocation of NF-κB and degradation of IκB, effects which were abolished by treatment with CZP. In addition, flow cytometry detected an increased production of endothelial microparticles in TNF-activated HAoECs, which was prevented by treatment with CZP. Conclusions: We have found at a cellular level that a clinically available TNF inhibitor, CZP reduces the expression of adhesion molecule expression, and prevents TNF-induced activation of the NF-κB pathway. Furthermore, CZP prevents the production of microparticles by activated endothelial cells. This could be central to the prevention of inflammatory environments underlying these conditions and measurement of microparticles has potential as a novel prognostic marker for future cardiovascular events in this patient group. Disclosure statement: Y.A. received a research grant from UCB. I.B. received a research grant from UCB. S.H. received a research grant from UCB. All other authors have declared no conflicts of interes

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes