The Road to Partnership: a Stepwise, Iterative Approach to Organisational Collaboration in RDM, Archives and Records Management

Research data management (RDM) sits at the confluence of a number of related roles. The shape an RDM confluence takes depends on several factors including the nature of an organisation and the research that it undertakes. At St George’s, University of London, the UK’s only university dedicated to medical and health sciences education, training and research, RDM has been intricately interwoven with organisational information governance roles since its inception. RDM is represented on our institutional Information Governance Steering Group and our Information Management Team consisting of information governance, data protection, freedom of information, archives, records management and RDM. This paper reports on how RDM, archives and records management have collaborated using a step-wise, iterative process to streamline and harmonise our guidance and workflows in relation to the stewardship, curation and preservation of research data. As part of this we consistently develop, conduct and evaluate small projects on managing, curating and preserving data. We present three projects that we collaborated on to transform research data services across each of our departments: planning for, conducting and reporting on interviews with wet laboratory researchers advocating, building a case for and delivering a university-wide digital preservation system ongoing work to recover, preserve and facilitate access to a unique national health database Learnings from these projects are used to develop our guidance, improve our activities and integrate our workflows, the outcomes of which may be further evaluated. Learnings are also used to improve our ways of working together. Through deeper integration of our activities and workflows, rather than simply aligning aspects of our work, we are increasingly becoming partners on research data stewardship, curation and preservation. This approach offers several benefits to the organisation as it allows us to build on our related knowledge and skills and deliver outcomes that demonstrate greater value to the organisation and the researchers we support

The Neural Circuitry of Sensory Processing in Post-traumatic Stress Disorder

Background: Traumatic experiences can have severe emotional and psychological consequences, which may affect the capacity to process both internal and external sensory information. Such aberrations may have cascading effects in individuals with post-traumatic stress disorder (PTSD), where alterations in sensory processing may hinder the capacity for higher-order executive functions, including emotion regulation. Delineating the neural circuitry of subcortical and cortical structures thought to be central to sensory processing is therefore critical to the study of PTSD and may help to develop an understanding of the neurobiological mechanisms underlying this often debilitating disorder. Methods: Various neuroimaging approaches were employed to investigate sensory processing in PTSD, its dissociative subtype, and healthy controls. First, resting-state connectivity patterns of subcortical brainstem structures linked to interoceptive and exteroceptive sensory processing, including the periaqueductal gray and the vestibular nuclei, were examined (chapters 2 and 3). In addition, given that the insula is critical for relaying exteroceptive and interoceptive sensory information to other neurocognitive networks in the brain, resting-state whole brain seed-based connectivity patterns of different insula subregions were investigated (chapter 4). Furthermore, machine learning analyses were used to assess the utility of insula subregion resting-state connectivity patterns as a diagnostic predictor for classifying PTSD, its dissociative subtype, and healthy controls. Finally, a task-based paradigm using oculomotor stimuli with simultaneous traumatic autobiographical memory recall was employed to examine cortical brain structures involved in the convergence of exteroceptive and interoceptive sensory information (chapter 5). Results and Discussion: As compared to controls, widespread periaqueductal gray connectivity was observed with cortical structures associated with emotional reactivity and defensive responding in PTSD and its dissociative subtype at rest. In addition, as compared to controls, decreased vestibular nuclei connectivity with cortical structures essential to exteroceptive sensory processing and multisensory integration was observed in individuals with the PTSD dissociative subtype. Moreover, PTSD showed limited cortical insula subregion resting-state connectivity with frontal lobe structures involved in the central executive network, which may be associated with impairment of higher-order executive functions, including emotion regulation, in PTSD. Finally, exposure to simultaneous exteroceptive and interoceptive sensory stimuli through oculomotor eye movements performed simultaneous to traumatic memory recall engaged the dorsal attentional network and default-mode frontoparietal networks that have been demonstrated to work in tandem to facilitate connectivity with structures in the central executive network, including the dorsolateral and dorsomedial prefrontal cortex, necessary for multisensory integration and emotion regulation. This effect was greater in individuals with PTSD and may provide a neurobiological account for how oculomotion may influence the frontoparietal cortical representation of traumatic memories. Overall, the findings of this dissertation reveal that individuals with PTSD experience aberrations in the neural circuitry necessary for processing both interoceptive and exteroceptive sensory information. We hypothesize that these observed alterations in interoceptive and exteroceptive neural processing may underlie, in part, the emotion dysregulation and maladaptive responses to chronic stress, including hypervigilance and dissociative symptoms, observed in PTSD and its dissociative subtype

Primary health care nursing students' perceptions of the case-based learning approach employed at a selected nursing education institution in Durban : an exploratory-descriptive study.

Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2013.Background: Case-based learning (CBL) is one approach which is gaining popularity. The selected School of Nursing adopted this approach to learning in 2000. The school reviewed all the old case studies and introduced new ones in 2010. These new case studies were used for the first time with the 2011 Decentralised PHC programme. Hence, the need for a study that explored students perceptions towards case-based learning. Research Methodology: A quantitative approach and descriptive exploratory design were adopted in this study. A total number of 101 students were from the three Decentralised Primary health care (PHC) programme participated in this study. Data was collected from three decentralised sites used to offer PHC programme to students; Durban, Port Shepstone and Pietermaritzburg. Data was collected by means of a questionnaire – a self-reporting instrument which included 62 structured questions. Data was analysed statistically for frequency distributions and the relationship between the results from three sites were explored using a Chi Square Pearson Test, with a p value set at .005. Results: The results of this study show that, overall, students view case-based learning in a positive light. Although the majority reported that cases were distributed in case study booklet form (n=66) 65.3%, other modes such as cases presented to students in each class session using transparencies (n=52) 51.5% as well as through emails was reported. Regarding benefits about (n=90) 90.1% of the respondents stated that cases presented added a lot of realism. The researcher also explored to see if there were any variations of results across the three delivery centres. The findings of this study demonstrated that there was a significant difference for seven items, some of these items included teachers feedback and advise after class was relevant for students to cope on their own p<.000; case studies preparing student for working in PHC institutions in South Africa p<.042; preferred lectures more than CBL p<.003 and CBL was too demanding in terms of preparation and the content p<.004. Discussion: Students enjoyed the experience but also identified their own limitations and mistakes. They were able to plan their own learning needs. The students experienced personal and professional growth using cases which represented the real-life challenges. They had the opportunity to apply the theory, their experiences and their newly developed skills from the use of CBL in there clinical practice. The end product was visible and of benefit to the clinical settings as students was now competent in analyzing cases and solving practical problems systematically. Providing a real-life challenge to students in CBL instead of teaching a predominantly theoretical course proved to be beneficial. Recommendations: The researcher felt that a follow-up study, taking into account all six sites where students are placed could result in a difference in the students’ perceptions of CBL as a teaching methodology, as the students in the other three sites are in the more rural areas which limits their resources. There was some inconsistency with presentation and distribution of cases also feedback to students, staff may require development with teaching skills to co-ordinate all centres in a similar way. Port Shepstone and Pietermaritzburg struggle with CBL, maybe they are not incline with Self directed learning (SDL), therefore a follow up study in these centres would assess in students are inclined with SDL

Narratives of curriculum adaptations: teacher challenges in the face of curriculum reform

Prior to the landmark 1994 democratic elections the South African education system was unequal and departmentalised. The transformation in South African politics was reflected in the changes implemented in the education curriculum. A massive shift in the basic education process was put into operation, in an attempt to create an amalgamated system which would equally benefit all learners (Hackenberg, 2002:20). These curriculum alterations created a lot of dissatisfaction and a sense of frustration among the teaching fraternity (Maphalala, 2006:7 and Knight, 2005:27). The basis of this study focuses on my concern that teachers, already tense and overworked, face many challenges when curriculum modifications occur, and may find it extremely difficult to cope with them. The associated challenges may lead to excess stress, adversity and teachers becoming ill. For this research study I evaluated how teachers confront and cope with the challenges associated with changes to curriculum. The method and success of these coping skills and the management of curriculum revision is directly linked to certain issues, which may exacerbate problems stemming from these changes and have negative effects of on the teachers themselves. This study is a narrative of teachers’ experiences and was primarily conducted in the Umlazi Circuit of the KwaZulu Natal Department of Education. Purposive sampling was utilised by me, whereby the respondents, teachers who had over twenty years of teaching experience, were carefully selected from four primary schools and one secondary school. The study used the qualitative research approach within the interpretive paradigm, allowing for an in-depth insight into the challenges faced by teachers with changes to the curriculum. Data was collected through semi-structured interviews and observation. The data was later analysed using codes, themes and categories. This analysis revealed that curriculum changes cause teachers to experience many challenges in the classroom. These challenges include, amongst others, lack of resources; discipline problems; excessive workloads; overcrowded classrooms; and insufficient professional development workshops

Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis.

Exposure to psychological trauma (for example, childhood/early life adversity, exposure to violence or assault, combat exposure, accidents or natural disasters) is known to increase one\u27s risk of developing certain chronic medical conditions. Clinical and population studies provide evidence of systemic inflammatory activity in trauma survivors with various psychiatric and nonpsychiatric conditions. This transdiagnostic meta-analysis quantitatively integrates the literature on the relationship of inflammatory biomarkers to trauma exposure and related symptomatology. We conducted random effects meta-analyses relating trauma exposure to log-transformed inflammatory biomarker concentrations, using meta-regression models to test the effects of study quality and psychiatric symptomatology on the inflammatory outcomes. Across k=36 independent samples and n=14,991 participants, trauma exposure was positively associated with C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α (mean rs =0.2455, 0.3067, 0.2890, and 0.2998, respectively). No significant relationships were noted with fibrinogen, IL-2, IL-4, IL-8, or IL-10. In meta-regression models, the presence of psychiatric symptoms was a significant predictor of increased effect sizes for IL-1β and IL-6 (β=1.0175 and 0.3568, respectively), whereas study quality assessment scores were associated with increased effect sizes for IL-6 (β=0.3812). Positive correlations between inflammation and trauma exposure across a range of sample types and diagnoses were found. Although reviewed studies spanned an array of populations, research on any one specific psychiatric diagnosis was generally limited to one or two studies. The results suggest that chronic inflammation likely represents one potential mechanism underlying risk of health problems in trauma survivors

Dietitian perceptions of low-calorie sweeteners

Background: Lowering energy (calorie) intake is essential in managing a healthy weight. One method of doing this is substituting sugar with low/no-calorie sweeteners. The safety of sweeteners has been debated, but little is known about how they are perceived by professionals responsible for weight management advice. We sought to explore dietitian perceptions of sweeteners and to identify the practical advice they provide about them

Integrating mobile technology with routine dietetic practice:The case of myPace for weight management

The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner–patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.</jats:p

Public safety personnel feedback from a remote trial of Goal Management Training for post-traumatic stress during Covid-19

Purpose: This paper explores participants’ perspectives on the acceptability, utility, and perceived therapeutic effects of a virtual group cognitive remediation program, Goal Management Training (GMT)™, during the COVID-19 pandemic. The advantages and drawbacks of these groups are considered as part of an online research study protocol exploring cognitive remediation among first responders (police, firefighters, paramedics, emergency dispatchers, corrections and parole officers, and nurses) who have been impacted by trauma. Methods: We qualitatively examined the results of an anonymous participant feedback survey collected from 20 first responders who took part in the first round of our online therapy groups. A thematic analysis approach was taken to highlight key themes and recommendations. Results: Survey results indicated that participants found our online protocol effective in terms of group facilitation, the utility of online platforms, and perceived therapeutic effects. Further, some participants preferred participating online versus attending in-person groups. Conclusion: This early data suggests that providing virtual options for research and treatment among trauma-impacted public safety personnel may increase accessibility and overall participation among this population

Dynamic Causal Modeling in PTSD and Its Dissociative Subtype: Bottom-Up Versus Top-Down Processing Within Fear and Emotion Regulation Circuitry

Posttraumatic stress disorder (PTSD) is associated with decreased top–down emotion modulation from medial prefrontal cortex (mPFC) regions, a pathophysiology accompanied by hyperarousal and hyperactivation of the amygdala. By contrast, PTSD patients with the dissociative subtype (PTSD + DS) often exhibit increased mPFC top–down modulation and decreased amygdala activation associated with emotional detachment and hypoarousal. Crucially, PTSD and PTSD + DS display distinct functional connectivity within the PFC, amygdala complexes, and the periaqueductal gray (PAG), a region related to defensive responses/emotional coping. However, differences in directed connectivity between these regions have not been established in PTSD, PTSD + DS, or controls. Methods: To examine directed (effective) connectivity among these nodes, as well as group differences, we conducted resting-state stochastic dynamic causal modeling (sDCM) pairwise analyses of coupling between the ventromedial (vm)PFC, the bilateral basolateral and centromedial (CMA) amygdala complexes, and the PAG, in 155 participants (PTSD [n = 62]; PTSD + DS [n = 41]; age-matched healthy trauma-unexposed controls [n = 52]). Results: PTSD was characterized by a pattern of predominant bottom–up connectivity from the amygdala to the vmPFC and from the PAG to the vmPFC and amygdala. Conversely, PTSD + DS exhibited predominant top–down connectivity between all node pairs (from the vmPFC to the amygdala and PAG, and from the amygdala to the PAG). Interestingly, the PTSD + DS group displayed the strongest intrinsic inhibitory connections within the vmPFC. Conclusions: These results suggest the contrasting symptom profiles of PTSD and its dissociative subtype (hyper- vs. hypo-emotionality, respectively) may be driven by complementary changes in directed connectivity corresponding to bottom–up defensive fear processing versus enhanced top–down regulation