Is practice placement capacity helping the NHS to recruit healthcare professionals?

YesPractice placements are a fundamental aspect of preparing students for working in the NHS and will influence where, and in what specialities, students work. Additionally, NHS leaders now consider the issues of recruitment and retention of NHS staff to be as serious as concerns over funding. NHS Providers have outlined the issues although there appears to be little, or no, consideration in terms of plans required for the most immediate future workforce. It is hypothesised that there is link between student healthcare placement capacity and workforce gaps. The policy of increasing training places and of funding practice placements may have a positive effect on practice placement provision and if so contribute to increasing the NHS workforce, but without further detail this impact remains unknown. Along with most aspects of service delivery, planning practice placements using the best available evidence will ensure that the impact on service delivery is minimised while maximising the experience for the next generation of NHS employees

Chronic myeloid leukemia cells require the bone morphogenic protein pathway for cell cycle progression and self-renewal

Leukaemic stem cell (LSC) persistence remains a major obstacle to curing chronic myeloid leukaemia (CML). The bone morphogenic protein (BMP) pathway is deregulated in CML, with altered expression and response to the BMP ligands shown to impact on LSC expansion and behaviour. In this study, we determined whether alterations in the BMP pathway gene signature had any predictive value for therapeutic response by profiling 60 CML samples at diagnosis from the UK SPIRIT2 trial and correlating the data to treatment response using the 18-month follow-up data. There was significant deregulation of several genes involved in the BMP pathway with ACV1C, INHBA, SMAD7, SNAIL1 and SMURF2 showing differential expression in relation to response. Therapeutic targeting of CML cells using BMP receptor inhibitors, in combination with tyrosine kinase inhibitor (TKI), indicate a synergistic mode of action. Furthermore, dual treatment resulted in altered cell cycle gene transcription and irreversible cell cycle arrest, along with increased apoptosis compared to single agents. Targeting CML CD34+ cells with BMP receptor inhibitors resulted in fewer cell divisions, reduced numbers of CD34+ cells and colony formation when compared to normal donor CD34+ cells, both in the presence and absence of BMP4. In an induced pluripotent stem cell (iPSC) model generated from CD34+ hematopoietic cells, we demonstrate altered cell cycle profiles and dynamics of ALK expression in CML-iPSCs in the presence and absence of BMP4 stimulation, when compared to normal iPSC. Moreover, dual targeting with TKI and BMP inhibitor prevented the self-renewal of CML-iPSC and increased meso-endodermal differentiation. These findings indicate that transformed stem cells may be more reliant on BMP signalling than normal stem cells. These changes offer a therapeutic window in CML, with intervention using BMP inhibitors in combination with TKI having the potential to target LSC self-renewal and improve long-term outcome for patients

Determination of Optical Constants for Titan Aerosol-, and Exoplanet and Brown Dwarf Cloud Particle Analogs from the Visible to the Far Infrared

Here we present optical constants covering a broad wavelength range, from the visible to the far infrared, for Titan aerosol analogs produced in the Titan Haze Simulation (THS) experiment at Ames COSmIC facility, as well as other exoplanet-relevant materials

Clues on syntenic relationship among some species of Oryzomyini and Akodontini Tribes (Rodentia: Sigmodontinae)

Sigmodontinae rodents represent one of the most diverse and complex components of the mammalian fauna of South America. Among them most species belongs to Oryzomyini and Akodontini tribes. The highly specific diversification observed in both tribes is characterized by diploid complements, which vary from 2n=10 to 86. Given this diversity, a consistent hypothesis about the origin and evolution of chromosomes depends on the correct establishment of synteny analyzed in a suitable phylogenetic framework. The chromosome painting technique has been particularly useful for identifying chromosomal synteny. In order to extend our knowledge of the homeological relationships between Akodontini and Oryzomyini species, we analyzed the species Akodon montensis (2n=24) and Thaptomys nigrita (2n=52) both from the tribe Akodontini, with chromosome probes of Hylaeamys megacephalus (2n=54) of the tribe Oryzomyini. The results indicate that at least 12 of the 26 autosomes of H. megacephalus show conserved synteny in A. montensis and 14 in T. nigrita. The karyotype of Akodon montensis, as well as some species of the Akodon cursor species group, results from many chromosomal fusions and therefore the syntenic associations observed probably represent synapomorphies. Our finding of a set of such associations revealed by H. megacephalus chromosome probes (6/21; 3/25; 11/16/17; and, 14/19) provides phylogenetic information for both tribes. An extension of these observations to other members of Akodontini and Oryzomyini tribes should improve our knowledge about chromosome evolution in both these groups.Fil: Suarez, Pablo. Universidad Federal de Pará; BrasilFil: Nagamachi, Cleusa Yoshiko. Universidad Federal de Pará; BrasilFil: Lanzone, Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Misiones. Facultad de Humanidades y Ciencias Sociales. Departamento de Genética. Laboratorio de Genética Evolutiva y Molecular; ArgentinaFil: Malleret, Matias Maximiliano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Misiones. Facultad de Humanidades y Ciencias Sociales. Departamento de Genética. Laboratorio de Genética Evolutiva y Molecular; ArgentinaFil: O'Brien, Patricia Caroline Mary. University of Cambridge; Reino UnidoFil: Ferguson Smith, Malcolm Andrew. University of Cambridge; Reino UnidoFil: Pieczarka, Julio Cesar. Universidad Federal de Pará; Brasi

A systematic review of core implementation components in team ball sport injury prevention trials

Abstract BACKGROUND: Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. OBJECTIVES: To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. METHODS: Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. RESULTS: The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83%), education/instruction in how to deliver an IPEP in three trials (6%) and multiple types of interventions (including an IPEP) in six trials (12%). Players were the most commonly reported intervention target (88%, n=46), followed by multiple targets (8%, n=4) and coaches (4%, n=2). Of the 25 trials for which delivery agents were reported, 13 (52%) reported a single type of delivery agent and 12 (48%) multiple types. The types of delivery agents reported included coaches, physiotherapists, athletic trainers and team captains. CONCLUSIONS: The current reporting of core implementation components in team ball sport IPEP trials is inadequate. In many trial reports, it is unclear whether researchers delivered the IPEP directly to players themselves or engaged delivery agents (eg, coaches, physiotherapists, athletic trainers) to deliver the programme. When researchers do interact with delivery agents, the education/instruction of delivery agents should be acknowledged as an intervention component and the delivery agents as an intervention target. Detailed reporting of implementation components in team ball sport IPEP trials will facilitate the successful replication of these interventions by intended users in practice and by researchers in other studies

Injury prevention exercise programmes in professional youth soccer : Understanding the perceptions of programme deliverers

BACKGROUND: There are well-known challenges to implementing injury prevention strategies in amateur soccer, but information from other soccer settings is scarce. This cross-sectional survey analysed the injury prevention perceptions of soccer coaches, fitness coaches and physiotherapists from 4 male teams in a professional youth soccer academy. METHODS: The respondents (n=18) completed a web-based survey relating to lower limb (LL) soccer injuries, the value and practicality of injury prevention exercise programmes (IPEPs) in general and, more specifically, the IPEP endorsed by FIFA, the FIFA 11+. RESULTS: There were very high levels of agreement regarding players' susceptibility to LL injury and the seriousness of these injuries. Respondents agreed unanimously that players should perform evidence-based injury prevention exercises. Despite 61% of respondents having previously heard of the FIFA 11+, just 6% reported current use of the full programme, with a further 22% reporting modified use. 22% believed the FIFA 11+ contained adequate variation and progression for their team and 78% felt it needed improvement. Respondents identified multiple barriers and facilitators to maintaining IPEPs, relating either to the programme content (eg, exercise variation), or the delivery and support of the programme (eg, coach acceptance). CONCLUSIONS: The coaches, fitness coaches and physiotherapists of professional youth teams support the use of IPEPs, but enhancing their impact requires tailoring of programme content, along with adequate delivery and support at multiple levels. The findings suggest that the FIFA 11+ needs modification for use in professional youth soccer teams

A Comparison of Two Intervention Strategies on the Academic Performance of Student-Athletes

The purpose of this study was to determine the effect of the Model Student Tutor Program (MSTP) when compared with the traditional study table on the academic performance of football players at the University of Wisconsin-LaCrosse as measured by grades acquired in selected courses. The subjects for this study consisted of eighty-one football players from a Division Ill program, the University of Wisconsin-La Crosse, in the fall semester of 1989. Participants registered in Biology 100 were randomly assigned to one of three groups: one group receiving peer tutoring, one group assigned to the traditional study table, and a control group. Participants registered in 100 level English and history were randomly assigned to one of three groups: one group receiving peer tutoring, one group assigned to the traditional study table, and a control group. Neither of the control groups received the academic intervention. ACT (composite, English, and science) scores were tested for pre-disposing differences. Three hypotheses were developed. The first hypothesis stated that there will be no significant difference in the grades of football players based on the type of intervention for literature-based courses. The second hypothesis stated that there will be no significant difference in the grades of football players, based on the type of intervention for science-based courses. The third hypothesis stated that there will be no significant difference in the grades of football players based on the type of intervention used across course content. Based on the results of an ANOVA, the first hypothesis was rejected while the second and third hypotheses were retained. There was a significant difference between the study table and control group for literature courses. Neither peer tutoring nor study table was significantly effective in improving the performance of football players in science-based classes. It could not be shown that study table or peer tutoring would be more effective if one had to choose between interventions regardless of course content

Transient anabolic effects accompany epidermal growth factor receptor signal activation in articular cartilage in vivo

INTRODUCTION: Signals from the epidermal growth factor receptor (EGFR) have typically been considered to provide catabolic activities in articular cartilage, and accordingly have been suggested to have a causal role in osteoarthritis progression. The aim of this study was to determine in vivo roles for endogenous EGFR signal activation in articular cartilage. METHODS: Transgenic mice with conditional, limb-targeted deletion of the endogenous intracellular EGFR inhibitor Mig-6 were generated using CreLoxP (Mig-6-flox; Prx1Cre) recombination. Histology, histochemical staining and immunohistochemistry were used to confirm activation of EGFR signaling in the articular cartilage and joints, and to analyze phenotypic consequences of Mig-6 loss on articular cartilage morphology, proliferation, expression of progenitor cell markers, presence of chondrocyte hypertrophy and degradation of articular cartilage matrix. RESULTS: The articular cartilage of Mig-6-conditional knockout (Mig-6-cko) mice was dramatically and significantly thicker than normal articular cartilage at 6 and 12 weeks of age. Mig-6-cko articular cartilage contained a population of chondrocytes in which EGFR signaling was activated, and which were three to four times more proliferative than normal Mig-6-flox articular chondrocytes. These cells expressed high levels of the master chondrogenic regulatory factor Sox9, as well as high levels of putative progenitor cell markers including superficial zone protein (SZP), growth and differentiation factor-5 (GDF-5) and Notch1. Expression levels were also high for activated β-catenin and the transforming growth factor beta (TGF-β) mediators phospho-Smad2/3 (pSmad2/3). Anabolic effects of EGFR activation in articular cartilage were followed by catabolic events, including matrix degradation, as determined by accumulation of aggrecan cleavage fragments, and onset of hypertrophy as determined by type × collagen expression. By 16 weeks of age, the articular cartilage of Mig-6-cko knees was no longer thickened and was degenerating. CONCLUSIONS: These results demonstrate unexpected anabolic effects of EGFR signal activation in articular cartilage, and suggest the hypothesis that these effects may promote the expansion and/or activity of an endogenous EGFR-responsive cell population within the articular cartilage