Assessing competence in practice: to tech or not to tech? Piloting an electronic practice assessment document

This poster presents a 'work-in-progress' evaluation of a project to pilot MyProgress for their practice assessment documents (PAD) with undergraduate Bachelor of Midwifery (Hons) students

CAMERA - complete assessment of elderly patients with cancer: A non-randomised feasibility study

One of the primary risk factors in the development of cancer is older age. The demographic shift to an ageing population has given rise to an increased number of older patients with cancer. The extreme heterogeneity within this population renders applying standardised treatment pathways hazardous [1]. Disparities in physiological reserve and an increased risk of multiple comorbidities further exacerbates the complexity of cancer treatment management in older patients [2]. Individual modifications to tailor treatment for each specific patient would be the gold standard; thus, detailed patient assessment providing a comprehensive health profile in addition to existing diagnostic test results are paramount when devising a personalised treatment care approach [3]

Guidance impact on primary care prescribing rates of simple analgesia: an interrupted time series analysis in England

Background: In March 2018, NHS England published guidance for Clinical Commissioning Groups (CCGs; NHS bodies that commission health services for local areas) to encourage implementation of policy to reduce primary care prescriptions of over-the-counter medications, including simple analgesia. Aims: To investigate: the impact of guidance publication on prescribing rates of simple analgesia (oral paracetamol, oral ibuprofen and topical non-steroidal anti-inflammatory drugs [NSAIDS]) in primary care; CCG implementation intentions; and whether it has created a health inequality based on socioeconomic status. Design and Setting: Interrupted time series analysis of primary care prescribing data in England. Methods: Practice-level prescribing data from January 2015 to March 2019 were obtained from NHS Digital. Interrupted time series analyses assessed the association of guidance publication with prescribing rates. The association between practice-level prescribing rates and Index of Multiple Deprivation score (a marker of socioeconomic deprivation) before and after publication was quantified using multivariable Poisson regression. Freedom of information requests were submitted to all CCGs. Results: There was a 4% reduction in prescribing of simple analgesia following guidance publication (adjusted incidence rate ratio [aIRR] 0.96, 95% CI 0.92-0.99, p=0.027), adjusting for underlying time trend and seasonality. Practice-level prescribing rates were greater in more deprived areas. There was considerable diversity across CCGs in whether or how they chose to implement the guidance. Conclusion: Guidance publication was associated with a small reduction in the prescribing rates of simple analgesia across England, without evidence of creating an additional health inequality. Careful implementation by CCGs would be required to optimise cost-saving to the NHS

A rapidly acquired foraging-based working memory task, sensitive to hippocampal lesions, reveals age-dependent and age-independent behavioural changes in a mouse model of amyloid pathology

© 2018 Elsevier Inc. Three experiments examined the ability of mice to forage efficiently for liquid rewards in pots located in an open field arena. Search behaviour was unconstrained other than by the walls of the arena. All mice acquired the task within 4 days of training, with one trial per day. Experiment 1 tested the hypothesis that hippocampal lesions would disrupt foraging behaviour using extramaze cues. Mice with hippocampal lesions showed normal latency to initiate foraging and to complete the task relative to sham-operated mice. However, lesioned mice showed increased perseverative responding (sensitization) to recently rewarded locations, increased total working memory errors and an increased propensity to search near previously rewarded locations. In Experiment 2, the extramaze cues were obscured and each pot was identified by a unique pattern. Under these conditions, mice with hippocampal lesions showed comparable working memory errors to control mice. However, lesioned mice continued to display increased perseverative responding and altered search strategies. Experiment 3 tested the hypothesis that age-related accumulation of amyloid would disrupt foraging behaviour in transgenic PDAPP mice expressing the V717F amyloid precursor protein (APP) mutation. Consistent with previous findings, PDAPP mice showed both age-dependent and age-independent behavioural changes. More specifically, 14–16 month-old PDAPP mice showed a deficit in perseverative responding and working memory errors. In contrast, changes in search behaviour, such as systematic circling, were present throughout development. The latter indicates that APP overexpression contributed to some features of the PDAPP behavioural phenotype, whereas working memory and flexible responding was sensitive to ageing and β-amyloid burden. In conclusion, the present study provided novel insight into the role of the hippocampus and the effects of APP overexpression on memory and search behaviour in an open-field foraging task

The Winchcombe meteorite – a regolith breccia from a rubble-pile CM chondrite asteroid

The Winchcombe meteorite is a CM chondrite breccia composed of eight distinct lithological units plus a cataclastic matrix. The degree of aqueous alteration varies between intensely altered CM2.0 and moderately altered CM2.6. Although no lithology dominates, three heavily altered rock types (CM2.1-2.3) represent >70 area%. Tochilinite-cronstedtite intergrowths (TCIs) are common in several lithologies. Their compositions can vary significantly, even within a single lithology, which can prevent a clear assessment of alteration extent if only TCI composition is considered. We suggest this is due to early alteration under localised geochemical microenvironments creating a diversity of compositions and because later reprocessing was incomplete, leaving a record of the parent body’s fluid history. In Winchcombe fragments of primary accretionary rock are held within a cataclastic matrix (~15 area%). This material is impact-derived fallback debris. Its grain size and texture suggest that the disruption of the original parent asteroid responded by intergranular fracture at grain sizes <100 µm, while larger phases, such as whole chondrules, splintered apart. Re-accretion formed a poorly lithified body. During atmospheric entry, the Winchcombe meteoroid broke apart with new fractures preferentially cutting through the weaker cataclastic matrix and separating the breccia into its component clasts. The strength of the cataclastic matrix imparts a control on the survival of CM chondrite meteoroids. Winchcombe’s unweathered state and diversity of lithologies makes it an ideal sample for exploring the geological history of the CM chondrite group.Additional authors: H. Mansour, S. Piazolo, T. Salge, R. Heard, R. Findlay, A. J. King, H. C. Bates, M. R. Lee, N. R. Stephen, F. M. Willcocks, R. C. Greenwood, I. A. Franchi, S. S. Russell, C. S. Harrison, P. F. Schofield, N. V. Almeida, C. Floyd, P.-E. Martin, K. H. Joy, P. J. Wozniakiewicz, D. Hallatt, M. J. Burchell, L. S. Alesbrook, V. Spathis, L. T. Cornwell, A. Digna

Pharmacogenetic meta-analysis of genome-wide association studies of LDL cholesterol response to statins

Statins effectively lower LDL cholesterol levels in large studies and the observed interindividual response variability may be partially explained by genetic variation. Here we perform a pharmacogenetic meta-analysis of genome-wide association studies (GWAS) in studies addressing the LDL cholesterol response to statins, including up to 18,596 statin-treated subjects. We validate the most promising signals in a further 22,318 statin recipients and identify two loci, SORT1/CELSR2/PSRC1 and SLCO1B1, not previously identified in GWAS. Moreover, we confirm the previously described associations with APOE and LPA. Our findings advance the understanding of the pharmacogenetic architecture of statin response