Improving the quantitative research skills of Welsh Baccalaureate teachers through university engagement

In 2015 the re-designed Welsh Baccalaureate Qualification (WBQ) was launched and, for the first time, students undertaking the qualification were required to complete the Skills Challenge Certificate (SCC). Consisting of four components: the Individual Project, the Enterprise and Employability Challenge, the Global Citizenship Challenge, and the Community Challenge, the SCC aims to enable learners to develop seven skills needed for education, employment and life. The Individual Project requires students to undertake a research project that includes analysing data using/utilising quantitative data analysis skills. This paper identifies the teaching of such quantitative skills as a difficulty for some teachers involved in the delivery of the qualification drawing on recent engagement work between Cardiff University and schools and colleges in South Wales. It argues that universities have an opportunity to engage with schools, teachers and pupils in the delivery of quantitative research skills that can be beneficial for both schools and universities

High optode-density wearable diffuse optical probe for monitoring paced breathing hemodynamics in breast tissue

Significance: Diffuse optical imaging (DOI) provides in vivo quantification of tissue chromophores such as oxy- and deoxyhemoglobin ([Formula: see text] and HHb, respectively). These parameters have been shown to be useful for predicting neoadjuvant treatment response in breast cancer patients. However, most DOI devices designed for the breast are nonportable, making frequent longitudinal monitoring during treatment a challenge. Furthermore, hemodynamics related to the respiratory cycle are currently unexplored in the breast and may have prognostic value. Aim: To design, fabricate, and validate a high optode-density wearable continuous wave diffuse optical probe for the monitoring of breathing hemodynamics in breast tissue. Approach: The probe has a rigid-flex design with 16 dual-wavelength sources and 16 detectors. Performance was characterized on tissue-simulating phantoms, and validation was performed through flow phantom and cuff occlusion measurements. The breasts of [Formula: see text] healthy volunteers were measured while performing a breathing protocol. Results: The probe has 512 unique source–detector (S-D) pairs that span S-D separations of 10 to 54 mm. It exhibited good performance characteristics: [Formula: see text] drift of 0.34%/h, [Formula: see text] precision of 0.063%, and mean [Formula: see text] up to 41 mm S-D separation. Absorption contrast was detected in flow phantoms at depths exceeding 28 mm. A cuff occlusion measurement confirmed the ability of the probe to track expected hemodynamics in vivo. Breast measurements on healthy volunteers during paced breathing revealed median signal-to-motion artifact ratios ranging from 8.1 to 8.7 dB. Median [Formula: see text] and [Formula: see text] amplitudes ranged from 0.39 to [Formula: see text] and 0.08 to [Formula: see text] , respectively. Median oxygen saturations at the respiratory rate ranged from 82% to 87%. Conclusions: A wearable diffuse optical probe has been designed and fabricated for the measurement of breast tissue hemodynamics. This device is capable of quantifying breathing-related hemodynamics in healthy breast tissue

Acting on Reflection: the Effect of Reflection on Students’ Clinical Performance on a Standardized Patient Examination

BACKGROUND: Little evidence exists to support the value of reflection in the clinical setting. OBJECTIVE: To determine whether reflecting and revisiting the “patient” during a standardized patient (SP) examination improves junior medical students’ performance and to analyze students’ perceptions of its value. DESIGN: Students completed a six-encounter clinical skills examination, writing a guided assessment after each encounter to trigger reflection. SPs evaluated the students with Medical Skills and Patient Satisfaction checklists. During the last three encounters, students could opt to revisit the SP and be reevaluated with identical checklists. PARTICIPANTS: One hundred and forty-nine third year medical students. MEASUREMENTS: Changes in scores in the Medical Skills and Patient Satisfaction checklists between first visit and revisit were tested separately per case as well as across cases. RESULTS: On the medical skills and patient satisfaction checklists, mean revisit scores across cases were significantly higher than mean first visit scores [12.6 vs 12.2 (pooled SD = 2.4), P = .0001; 31.2 vs 31.0 (pooled SD = 3.5), P = .0001)]. Sixty-five percent of the time, students rated “reflect–revisit” positively, 34% neutrally, and 0.4% negatively. Five themes were identified in the positive comments: enhancement of (1) medical decision making, (2) patient education/counseling, (3) student satisfaction/confidence, (4) patient satisfaction/confidence, and (5) clinical realism. CONCLUSIONS: Offering third year medical students the option to reflect and revisit an SP during a clinical skills examination produced a small but nontrivial increase in clinical performance. Students perceived the reflect–revisit experience as enhancing patient-centered practices (counseling, education) as well as their own medical decision making and clinical confidence

Homelessness and natural disasters: the role of community service organisations

Homelessness can decrease the disaster resilience of individuals and communities. This paper presents the findings of ten in-depth qualitative interviews conducted at a homelessness support service to explore homeless individual's experiences of natural hazards and how they access support during disasters. Thematic analysis identified three themes: disconnection (isolation causing a reliance on non-durable forms of support), service provider trust (participants accessed services they trusted) and personal disaster (homelessness increased vulnerability to relatively minor natural hazards). Findings were applied to the role of community service organisations (CSOs) using the Adaptive Cycle of Resilience as a framework. The results imply that CSOs could minimise structural pre-disaster vulnerability by engaging people who are homeless in disaster preparedness and response activities. Disaster plans need to be ` all-people' and provide tailored support for the needs of specific populations. These plans could include word-ofmouth information, emphasising the strengths of people who are homeless and anticipating their priorities during disaster. CSOs could also employ vulnerability mapping to prepare for the needs of homeless populations. The impacts of disasters should be assessed in the context of an individual's exposure and vulnerability to their effects. Disaster recovery provides opportunities to promote strengths and increase social integration for people who are homeless

Turning points, identity, and social capital: a meta-ethnography of methamphetamine recovery

Despite the increasing prevalence and distinct nature of methamphetamine-related harms, treatment models are limited, and relapse is common. Meta-ethnography has been increasingly used to synthesise qualitative health research and develop new concepts or theories. This meta-ethnography aimed to explore methamphetamine users' experiences of cessation, recovery, and relapse, to better understand how to tailor support for this population.A systematic review was conducted of six electronic databases, supported by hand searches of leading journals and reviews of reference lists. Reports were included that used naturalistic participant observation to examine methamphetamine cessation, recovery, and relapse with at least 50% of their sample. The life course approach to drug use was used to inform the process of data analysis and interpretation. The final sample was synthesised using Reciprocal Translation supported by open and axial coding.Nineteen sources were selected, thirteen of which were conducted in the United States. Two themes were identified: methamphetamine users are exposed to a range of relapse triggers, but also triggers for recovery, and their susceptibility to these triggers is largely determined by their social environment; and the process of recovery requires changes in personal and social identity which can be a barrier to recovery for some users.These findings present the concept of recovery triggers and highlight the role of wider risk environments in determining methamphetamine recovery, and the negative potential of social capital. These themes also address the ongoing debate regarding the agency of drug users, and the impact of this debate on drug user's experiences of recovery

Barriers to accessing sexual health services for transgender and male sex workers: a systematic qualitative meta-summary

Access to safe and effective sexual healthcare services for transgender and male sex workers (TMSW) is a human right. Globally, TMSW experience a higher prevalence of human immunodeficiency virus (HIV) and sexually transmitted infections than the general population or other sex workers, suggesting the existence of unique challenges for this group when accessing healthcare. A systematic database search identified 22 qualitative papers addressing barriers to accessing sexual healthcare services for TMSW. These papers were critically evaluated for adherence to best practice standards for qualitative research and research with sex workers. A coding process identified five themes. Stigma was the predominant barrier, and was divided into stigma related to sexuality, gender identity, HIV status, sex worker status, and internalised stigma. Other barriers were confidentiality concerns, sexual health literacy, fatalism, and structural barriers. Each of these themes were informed by the wider context of stigma. The literature presents a complex syndemic of social disadvantage and exclusion acting to produce and reinforce health disparities related to sexual health and access to screening and treatment for TMSW