Improving health care professionals' feedback on communication skills: Development of an on-line resource

Objective: This project aimed to develop an open-access on-line resource to assist health care professionals in providing effective feedback on patient-centered clinical and communication skills. The collaborative nature of the development of this learning resource is outlined and evaluation of its use is discussed. Methods: An inter-professional team of teaching staff from two London Universities employed a researcher to interview experienced clinical and academic health care professionals and gather examples of difficult feedback situations. Material was used to develop short video clips illustrating some common challenges in giving feedback on clinical and communication skills. Initial evaluation following use of the scenarios in workshops was undertaken by means of a “talking wall” technique. Results: Evaluation indicated that the resource enhanced the learning experience by providing realistic and challenging scenarios to focus discussion. Conclusion: Inter-professional working and piloting the use of the video scenarios in workshops enabled the improvement and refinement of an on-line staff development resource on feedback. Practical implications: The on-line resource is now available as an open access learning tool, with eight scenarios and guidelines for providing effective feedback in the academic or clinical setting. It can be used for self-study or as part of a group training session

A narrative inquiry into the identity formation of Chinese doctoral students in relation to study abroad

The present study explores a topic which has been under-studied to date, namely the identity formation of Chinese PhD students in relation to study abroad. Underpinned by Giddens' (1991) "reflexive project of the self", which privileges agency and reflexivity, and using a narrative inquiry approach, it presents four students' 'stories' collected through semi-structured interviews and focus group discussions in the form of a trajectory of development fro past to future. In building a picture of theways in which students' self-identity is shaped by and shapes their experience of study abroad, the stories illustrate individual agency, motivation, self-determination and reflexivity. In doing so, they challenge the essentialised view of Chinese students as a homogeneous and sometimes problematic group and point to implications for action by the host institutions

Effects of dietary vegetable oil on atlantic salmon hepatocyte fatty acid desaturation and liver fatty acid compositions

Fatty acyl desaturase activities, involved in the conversion of the C18 EFA, 18:2n-6 and 18:3n-3, to the highly unsaturated fatty acids (HUFA) 20:4n-6, 20:5n-3 and 22:6n-3, are known to be under nutritional regulation. Specifically, the activity of the desaturation/elongation pathway is depressed when animals, including fish, are fed fish oils rich in n-3HUFA compared to animals fed vegetable oils rich in C18 EFA. The primary aims of the present study were a) to establish the relative importance of product inhibition (n-3HUFA) versus increased substrate concentration (C18 EFA) and, b) to determine whether 18:2n-6 and 18:3n-3 differ in their effects, on the hepatic fatty acyl desaturation/elongation pathway in Atlantic salmon (Salmo salar). Smolts were fed ten experimental diets containing blends of two vegetable oils, linseed (LO) and rapeseed oil (RO), and fish oil (FO) in a triangular mixture design for 50 weeks. Fish were sampled after 32 and 50 weeks, lipid and fatty acid composition of liver determined, fatty acyl desaturation/elongation activity estimated in hepatocytes using [1-14C]18:3n-3 as substrate, and the data subjected to regression analyses. Dietary 18:2n-6 was positively correlated, and n-3HUFA negatively correlated, with lipid content of liver. Dietary 20:5n-3 and 22:6n-3 were positively correlated with liver fatty acids with a slope greater than unity suggesting relative retention and deposition of these HUFA. In contrast, dietary 18:2n-6 and 18:3n-3 were positively correlated with liver fatty acids with a slope of less than unity suggesting metabolism via β-oxidation and/or desaturation/elongation. Consistent with this, fatty acyl desaturation/elongation in hepatocytes was significantly increased by feeding diets containing vegetable oils. Dietary 20:5n-3 and 22:6n-3 levels were negatively correlated with hepatocyte fatty acyl desaturation. At 32 weeks, 18:2n-6 but not 18:3n-3, was positively correlated with hepatocyte fatty acyl desaturation activity whereas the reverse was true at 50 weeks. The data indicate that both feedback inhibition through increased n-3HUFA and decreased C18 fatty acyl substrate concentration are probably important in determining hepatocyte fatty acyl desaturation activities, and that 18:2n-6 and 18:3n-3 may differ in their effects on this pathway

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS).

BACKGROUND: People with asthma from ethnic minority groups experience significant morbidity. Culturally-specific interventions to reduce asthma morbidity are rare. We tested the hypothesis that a culturally-specific education programme, adapted from promising theory-based interventions developed in the USA, would reduce unscheduled care for South Asians with asthma in the UK. METHODS: A cluster randomised controlled trial, set in two east London boroughs. 105 of 107 eligible general practices were randomised to usual care or the education programme. Participants were south Asians with asthma aged 3 years and older with recent unscheduled care. The programme had two components: the Physician Asthma Care Education (PACE) programme and the Chronic Disease Self Management Programme (CDSMP), targeted at clinicians and patients with asthma respectively. Both were culturally adapted for south Asians with asthma. Specialist nurses, and primary care teams from intervention practices were trained using the PACE programme. South Asian participants attended an outpatient appointment; those registered with intervention practices received self-management training from PACE-trained specialist nurses, a follow-up appointment with PACE-trained primary care practices, and an invitation to attend the CDSMP. Patients from control practices received usual care. Primary outcome was unscheduled care. FINDINGS: 375 south Asians with asthma from 84 general practices took part, 183 registered with intervention practices and 192 with control practices. Primary outcome data were available for 358/375 (95.5%) of participants. The intervention had no effect on time to first unscheduled attendance for asthma (Adjusted Hazard Ratio AHR = 1.19 95% CI 0.92 to 1.53). Time to first review in primary care was reduced (AHR = 2.22, (1.67 to 2.95). Asthma-related quality of life and self-efficacy were improved at 3 months (adjusted mean difference -2.56, (-3.89 to -1.24); 0.44, (0.05 to 0.82) respectively. CONCLUSIONS: A multi-component education programme adapted for south Asians with asthma did not reduce unscheduled care but did improve follow-up in primary care, self-efficacy and quality of life. More effective interventions are needed for south Asians with asthma

Journeys from quantum optics to quantum technology

Sir Peter Knight is a pioneer in quantum optics which has now grown to an important branch of modern physics to study the foundations and applications of quantum physics. He is leading an effort to develop new technologies from quantum mechanics. In this collection of essays, we recall the time we were working with him as a postdoc or a PhD student and look at how the time with him has influenced our research

Baseline Assessment of Poultry Production, Pharmaceutical Product Use, and Related Challenges on Commercial Poultry Flocks in Kano and Oyo States of Nigeria

Poultry production is a major component of the livestock sector in Nigeria and continues to expand rapidly; however, it is still constrained by low productivity. A farm survey was conducted to provide a baseline assessment of poultry production (products generated, farm costs, and revenue), pharmaceutical use, and related challenges faced by farmers on 44 commercial poultry farms in Oyo and Kano states of Nigeria. Live spent layers, eggs, and used beddings were the most frequently sold products for revenue. Antibiotic products were widely used, the most reported were Doxygen, Tylosin, and Conflox. Overall, 40% of farms used feed additives (including toxin binders, minerals, and vitamins) and 12% used coccidiostats. Access to pharmaceutical products was a key challenge and appeared to disproportionally affect farmers in the northern part (Kano) of Nigeria. Other challenges included perceived antibiotic ineffectiveness, high cost of drugs, and long distances to pharmaceutical suppliers. Challenges related to vaccine use were unavailability, distance to the supplier, and health issues interfering with the vaccination schedule. Study findings highlight the need for improved access to veterinary pharmaceuticals, particularly in the northern states. Further investigations into the causes of antibiotic ineffectiveness and strategies for distribution of high-quality, effective pharmaceuticals are also necessary

Kaplan-Meier estimate of probability of attending for first episode of unscheduled asthma care by days since intervention

<p>Kaplan-Meier estimate of probability of attending for first episode of unscheduled asthma care by days since intervention</p

Adaptation of educational programmes

<p>Adaptation of educational programmes</p