Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study

AbstractQuestion: What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL) activities, compared to a traditional paired teaching approach? Design: Qualitative study utilising focus groups. Participants: Twenty-four physiotherapy students and 12 clinical educators. Intervention: Participants in this study had experienced two models of physiotherapy clinical undergraduate education: a traditional paired model (usual clinical supervision and learning activities led by clinical educators supervising pairs of students) and a PAL model (a standardised series of learning activities undertaken by student pairs and clinical educators to facilitate peer interaction using guided strategies). Results: Peer-assisted learning appears to reduce the students’ anxiety, enhance their sense of safety in the learning environment, reduce educator burden, maximise the use of downtime, and build professional skills including collaboration and feedback. While PAL adds to the clinical learning experience, it is not considered to be a substitute for observation of the clinical educator, expert feedback and guidance, or hands-on immersive learning activities. Cohesion of the student-student relationship was seen as an enabler of successful PAL. Conclusion: Students and educators perceive that PAL can help to position students as active learners through reduced dependence on the clinical educator, heightened roles in observing practice, and making and communicating evaluative judgments about quality of practice. The role of the clinical educator is not diminished with PAL, but rather is central in designing flexible and meaningful peer-based experiences and in balancing PAL with independent learning opportunities. Registration: ACTRN12610000859088. [Sevenhuysen S, Farlie MK, Keating JL, Haines TP, Molloy E (2015) Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study. Journal of Physiotherapy 61: 87–92

Apprentissages en profondeur et rencontres sociales dans un cours à distance

Afin de favoriser une meilleure compréhension des sujets à l’étude ainsi que l’entraide entre étudiants, des logiciels ont été introduits dans le cours de comptabilité de management offert à distance par la Téluq suivi par 35 étudiants : le logiciel de construction de cartes de connaissances ‘Xmind’, le logiciel social ‘Elgg’ et le logiciel de visioconférence ‘Enjeux’. Nous avons relevé 47 publications dans le logiciel social, comprenant plusieurs échanges de cartes construites avec le logiciel ‘Xmind’, mais aucune rencontre en équipe ne semble avoir eu lieu par visioconférence pour construire de telles cartes. Certains étudiants impliqués disent que la construction de cartes de connaissances leur a permis de faire des apprentissages en profondeur. Mais pour plusieurs, le temps semble avoir été la principale contrainte à une telle activité. Les objectifs visés (apprentissage en profondeur et collaboration) ont donc été atteints pour certains, mais pas pour d’autres.In order to support a better understanding of the subject matter and to favor peer support among students, softwares were introduced in accounting management, a distance education course offered by Téluq to 35 students. The softwares introduced include ‘Xmind’ for creating knowledge cards, the social software ‘Elgg’ and the videoconferencing software ‘Enjeux’. Although we observed 47 publications generated with the social software, used to exchange knowledge maps created with the ‘Xmind’ software, no group meetings to create knowledge maps were held by videoconference. Some of the students involved say that the construction of knowledge maps encouraged significant learning. But for several participants, time seems to have been the principal constraint for undertaking such an activity. Therefore, the objectives (deeper learning and cooperation) were achieved for some, but not for others

Decision-making about the use of hormone therapy among perimenopausal women

Women reaching menopause must make a controversial decision about whether to use hormone therapy (HT). The theory of planned behaviour (TPB) was the organizing framework. The objectives were to determine if (1) influence of different TPB constructs varied with stage of menopause and HT use, (2) women with diabetes were influenced in significantly different ways from women without, (3) the overall perceived behavioural control (PBC) and self-efficacy (SE) have independent effects on intention, and (4) physician influence was mediated by subjective norm (SN).Cross-sectional survey of women from a managed care organization.Multiple regression analysis was used to analyse 765 responses (230 from women with diabetes) and separately four main subgroups: (1) early menopause stage and never used HT, (2) late menopause stage and never used HT, (3) late menopause stage and previously used HT, and (4) late menopause stage currently using HT.For the entire sample, the model explains 68% of variance in intention, where SE, physicians' influence, self-identification with menopause as a natural part of ageing, self-identification as someone who wants to delay menopause, HT status, menopause status, and diabetes were added to the TPB. For the entire sample, SE added 2% to the explained variance and the physician determinant added 7%.An augmented TPB is useful for understanding women's HT use decisions. The theory explains more variance in intention before a behaviour is enacted than after, and decision structure changes over time. PBC and SE have independent effects on intention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79377/1/135910709X457946.pd

The Synthetic Biology Knowledge System

The Synthetic Biology Knowledge System (SBKS) is an instance of the SynBioHub repository that includes text and data information that has been mined from papers published in ACS Synthetic Biology. This paper describes the SBKS curation framework that is being developed to construct the knowledge stored in this repository. The text mining pipeline performs automatic annotation of the articles using natural language processing techniques to identify salient content such as key terms, relationships between terms, and main topics. The data mining pipeline performs automatic annotation of the sequences extracted from the supplemental documents with the genetic parts used in them. Together these two pipelines link genetic parts to papers describing the context in which they are used. Ultimately, SBKS will reduce the time necessary for synthetic biologists to find the information necessary to complete their designs. &nbsp;</p

The CCAT-Prime Submillimeter Observatory

The Cerro Chajnantor Atacama Telescope-prime (CCAT-prime) is a new 6-m, off-axis, low-emissivity, large field-of-view submillimeter telescope scheduled for first light in the last quarter of 2021. In summary, (a) CCAT-prime uniquely combines a large field-of-view (up to 8-deg), low emissivity telescope (< 2%) and excellent atmospheric transmission (5600-m site) to achieve unprecedented survey capability in the submillimeter. (b) Over five years, CCAT-prime first generation science will address the physics of star formation, galaxy evolution, and galaxy cluster formation; probe the re-ionization of the Universe; improve constraints on new particle species; and provide for improved removal of dust foregrounds to aid the search for primordial gravitational waves. (c) The Observatory is being built with non-federal funds (~ \$40M in private and international investments). Public funding is needed for instrumentation (~ \$8M) and operations (\$1-2M/yr). In return, the community will be able to participate in survey planning and gain access to curated data sets. (d) For second generation science, CCAT-prime will be uniquely positioned to contribute high-frequency capabilities to the next generation of CMB surveys in partnership with the CMB-S4 and/or the Simons Observatory projects or revolutionize wide-field, sub-millimetter line intensity mapping surveys.Comment: Astro2020 APC White Pape

Identification of a Novel Class of Farnesylation Targets by Structure-Based Modeling of Binding Specificity

Farnesylation is an important post-translational modification catalyzed by farnesyltransferase (FTase). Until recently it was believed that a C-terminal CaaX motif is required for farnesylation, but recent experiments have revealed larger substrate diversity. In this study, we propose a general structural modeling scheme to account for peptide binding specificity and recapitulate the experimentally derived selectivity profile of FTase in vitro. In addition to highly accurate recovery of known FTase targets, we also identify a range of novel potential targets in the human genome, including a new substrate class with an acidic C-terminal residue (CxxD/E). In vitro experiments verified farnesylation of 26/29 tested peptides, including both novel human targets, as well as peptides predicted to tightly bind FTase. This study extends the putative range of biological farnesylation substrates. Moreover, it suggests that the ability of a peptide to bind FTase is a main determinant for the farnesylation reaction. Finally, simple adaptation of our approach can contribute to more accurate and complete elucidation of peptide-mediated interactions and modifications in the cell

Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review

Prevention has become increasingly central in social care policy and commissioning strategies within the United Kingdom (UK). Commonly there is reliance on understandings borrowed from the sphere of public health, leaning on a prevention discourse characterised by the 'upstream and downstream' metaphor. Whilst framing both structural factors and responses to individual circumstances, the public health approach nonetheless suggests linearity in a cause and effect relationship. Social care and illness follow many trajectories and this conceptualisation of prevention may limit its effectiveness and scope in social care. Undertaken as part of a commissioned evaluation of the Social Services and Wellbeing Act (2014) Wales, a systematic integrative review was conducted to establish the key current debates within prevention work, and how prevention is conceptually framed, implemented and evaluated within the social care context. The databases Scopus, ASSIA, CINAHL and Social Care Online were initially searched in September 2019 resulting in 52 documents being incorporated for analysis. A further re-run of searches was run in March 2021, identifying a further 14 documents, thereby creating a total of 66. Predominantly, these were journal articles or research reports (n = 53), with the remainder guidance or strategy documents, briefings or process evaluations (n = 13). These were categorised by their primary theme and focus, as well as document format and research method before undergoing thematic analysis. This highlighted the continued prominence of three-tiered, linear public health narratives in the framing of prevention for social care, with prevention work often categorised and enacted with inconsistency. Common drivers for prevention activity continue to be cost reduction and reduced dependence on the care system in the future. Through exploring prevention for older people and caregivers, we argue for an approach to prevention aligning with the complexities of the social world surrounding it. Building on developments in complexity theory in social science and healthcare, we offer an alternative view of social care prevention guided by principles rooted in the everyday realities of communities, service users and caregivers

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council