Evaluation of the Villiers Park Scholars Programme

An evaluation of the Villiers Park Scholars Programme was carried out by Louise Gazeley, Judy Sebba, Sarah Aynsley and Angela Jacklin from the Department of Education at the University of Sussex between 2009 and 2011. The Villiers Park Scholars Programme identified young people from less advantaged backgrounds who displayed high academic potential and sought to improve their chances of gaining entry to 'centres of excellence at leading universities'. The evaluating team focused on tracking the impact of the programme on its first cohorts of scholars over a two year period. A multi-site case study approach was adopted for which data was collected in three phases for each of the 10 participating institutions. The main impact at school level related to improvements in the identification of high potential. Analysis of the quantitaive data showed Year 11 scholars in three schools performing favourably at GCSE level in relation to the top 25 per cent of their peer group. Feedback from the scholars themselves indicated that the mentoring they had received had contributed to changes in their academic and study skills that contributed to improved attainment. Staff, parents and scholars all felt that changes in the performance of identified scholars was seen in their motivation, self-esteem and confidence in particular. Greater impact was seen in relation to Year 11 scholars and those without a parent who had been to university. Staff and scholars also considered that the programme had improved scholars' knowledge of higher education. Analysis of the destinations data for Year 13 scholars revealed that around half of those for whom data was available took up places in 'leading' universities. Scholars who did not have a parent who went to university were found to be more likely to say that their involvement in the programme had changed their future plane

Effectiveness of Spinal Manipulation in the Treatment of Non-Musculoskeletal Disorders: A Systematic Review

Purpose: Perform a systematic review to determine if spinal manipulation (SM) is an effective treatment for non-musculoskeletal disorders. Subjects: Four studies from peer-reviewed journals that met inclusion/exclusion criteria were reviewed. Materials & Methods: Pubmed, PEDro, Chiropractic Literature, CINAHL, Cochrane were searched between March and April 2014. In order to assess methodological quality, three raters applied the PEDro scale to included studies. Results: The initial search yielded 2,324 articles covering 45 non-musculoskeletal conditions. Four randomized control trials (RCTs), met inclusion criteria. The conditions covered included: inner ear infection, infantile colic, asthma, and chronic obstructive pulmonary disease. Pedro scores ranged from 6-8, with a mean score of 7.25±.957, indicating fair to good methodological quality. Two studies reported significant improvement between groups for forced vital capacity, 6MWT and dyspnea scores for individuals with COPD and self-reported quality of life and symptom severity for individuals with asthma. Two studies found no statistically significant changes in physiologic or self-reported outcomes. Conclusions: Although, there were significant improvements in some outcome measures, the applicability of these results is limited by the poor methodological design of the studies, making it impossible to attribute these improvements to SM, alone. Therefore, there is no conclusive evidence that supports the use of SM as a treatment for non-musculoskeletal disorders. Clinical Relevance: It is imperative to investigate the possible benefits of SM in order to provide evidence based treatment to individuals with non-musculoskeletal conditions. This reviews illuminates the need for higher quality research when examining the effect of SM on non-musculoskeletal disorders

Pilot Evaluation of a Narrative-based Listening and Communication Skills Game: Oracle

Gamification in an educational context has been shown to be a valuable tool to learners and educators in a diverse range of environments both inside and outside higher education. We have invented a narrative-based card game called “Oracle” that can be played by between 2 – 5 players, intended to aid development of both listening and communication skills through play. We provided the game to a mixed gender group of pre-university students as part of a larger session on developing communication skills to explore their perceptions of a game-based approach to this. We asked for anonymous self-evaluated perceptions of both listening and communication skills pre- and post- gameplay using a 5-point Likert scale. Our pilot data shows a positive perception of our game-based approach to engaging with listening and communication skill development, as well as positive perceptions of improvements in communication and listening skills. We therefore hypothesise that using a narrative-driven game to support and develop communication and listening skills offers a range of positive benefits that may be transferable to other disciplines, such as medical and legal education. Our future work will look to refine and develop Oracle to better capitalise on these benefits, as well as to explore different learning contexts where the use of Oracle could be adopted or adapted

Fluorescent Imaging of Antigen Released by a Skin-Invading Helminth Reveals Differential Uptake and Activation Profiles by Antigen Presenting Cells

Infection of the mammalian host by the parasitic helminth Schistosoma mansoni is accompanied by the release of excretory/secretory molecules (ES) from cercariae which aid penetration of the skin. These ES molecules are potent stimulants of innate immune cells leading to activation of acquired immunity. At present however, it is not known which cells take up parasite antigen, nor its intracellular fate. Here, we develop a technique to label live infectious cercariae which permits the imaging of released antigens into macrophages (MΦ) and dendritic cells (DCs) both in vitro and in vivo. The amine reactive tracer CFDA-SE was used to efficiently label the acetabular gland contents of cercariae which are released upon skin penetration. These ES products, termed ‘0-3hRP’, were phagocytosed by MHC-II+ cells in a Ca+ and actin-dependent manner. Imaging of a labelled cercaria as it penetrates the host skin over 2 hours reveals the progressive release of ES material. Recovery of cells from the skin shows that CFDA-SE labelled ES was initially (3 hrs) taken up by Gr1+MHC-II− neutrophils, followed (24 hrs) by skin-derived F4/80+MHC-IIlo MΦ and CD11c+ MHC-IIhi DC. Subsequently (48 hrs), MΦ and DC positive for CFDA-SE were detected in the skin-draining lymph nodes reflecting the time taken for antigen-laden cells to reach sites of immune priming. Comparison of in vitro-derived MΦ and DC revealed that MΦ were slower to process 0-3hRP, released higher quantities of IL-10, and expressed a greater quantity of arginase-1 transcript. Combined, our observations on differential uptake of cercarial ES by MΦ and DC suggest the development of a dynamic but ultimately balanced response that can be potentially pushed towards immune priming (via DC) or immune regulation (via MΦ)

‘Creative Weird’: Exploring gamification of communication and listening skills through play.

Gamification has been a key emerging pedagogic approach in developing multiple skills through playful learning. In this article, we hypothesise that using a narrative-driven physical card game improves communication and listening skills in players through building an encouraging and engaging user experience. Our evaluation from two player groups of students revealed engagement and confidence improvements in both communication and listening skills development. Our findings also showed improvement of player self-awareness of these critical skills as well as highly reflective commentary related to communicating in professional contexts. We conclude there are more elements of interprofessional and interpersonal learning that can be improved and supported through similar playful learning approaches achieved through use of gamification-based interventions such as we describe here

Pedagogic development of a gamified approach to enhancing engagement in interprofessional education

Inter-professional education (IPE) is an integral part of learning for undergraduate healthcare students. From the evidence in the literature about the benefits of linked learning, collaboration between the health professions early in student development can lead to improved patient outcomes. This article reflects on the adoption at Keele University in the United Kingdom (UK), of a novel approach to introducing inter-professional education – with the intention of increasing interest in undergraduate health students across the Health faculty. A card-based scenario game (a ‘Braincept’ game) in the style of a pub quiz introduced elements of gamification, in order to engage students and increase their awareness of various healthcare professionals’ roles and interactions. This article assesses the impact of using gamification elements and outlines pedagogic principles underpinning development of this novel intervention

The Mannose Receptor (CD206) is an important pattern recognition receptor (PRR) in the detection of the infective stage of the helminth Schistosoma mansoni and modulates IFNγ production.

In this study, infective larvae of the parasitic helminth Schistosoma mansoni were shown to contain a large number of glycosylated components specific for the Mannose Receptor (MR; CD206), which is an important pattern recognition receptor (PRR) of the innate immune system. MR ligands were particularly rich in excretory/secretory (E/S) material released during transformation of cercariae into schistosomula, a process critical for infection of the host. E/S material from carboxyfluorescein diacetate succinimidyl ester (CFDA-SE)-labelled cercariae showed enhanced binding by cells lines that over-express the MR. Conversely, uptake was significantly lower by bone marrow-derived macrophages (MΦ) from MR(-/-) mice, although they were more active as judged by enhanced pro-inflammatory cytokine production and CD40 expression. After natural percutaneous infection of MR(-/-) mice with CFDA-SE-labelled parasites, there were fewer cells in the skin and draining lymph nodes that were CFDA-SE(+) compared with wild-type mice, implying reduced uptake and presentation of larval parasite antigen. However, antigen-specific proliferation of skin draining lymph node cells was significantly enhanced and they secreted markedly elevated levels of IFNγ but decreased levels of IL-4. In conclusion, we show that the MR on mononuclear phagocytic cells, which are plentiful in the skin, plays a significant role in internalising E/S material released by the invasive stages of the parasite which in turn modulates their production of pro-inflammatory cytokines. In the absence of the MR, antigen-specific CD4(+) cells are Th1 biased, suggesting that ligation of the MR by glycosylated E/S material released by schistosome larvae modulates the production of CD4(+) cell specific IFNγ

Living with myocardial ischaemia and no obstructive coronary arteries: a qualitative study

Objective To explore the lived experience of people with myocardial ischaemia with no obstructive arteries. Design Qualitative study using semistructured interviews. Setting Telephone interviews with 17 participants living in the UK. Participants 17 people (2 males, 15 females; aged 31–69 years) with a presumed or confirmed diagnosis of myocardial ischaemia with no obstructive arteries, recruited via social media and online patient-led support forums. Results Five themes were generated. Theme 1 describes the wide range of experiences that participants described, particularly the frequency and intensity of symptoms, and the uncertainty and fear that symptoms commonly provoked. Theme 2 describes the major impact on social relationships, employment and other aspects of everyday life. Theme 3 illustrates challenging and traumatising experiences participants described around pathways to diagnosis and accessing medical support. Theme 4 highlights the lack of consensus and clarity that participants had been confronted with around treatment and management. Theme 5 describes coping and supportive strategies valued by participants. Conclusions This study provides insight into the challenges of living with myocardial ischaemia with no obstructive arteries. Findings highlight the significant psychological impact on people living with these conditions and the need for improvements in diagnosis, support and long-term management

Training healthcare professionals to be ready for practice in an era of social distancing: A realist evaluation

Background Programme changes due to the COVID-19 pandemic have impacted variably on preparation for practice of healthcare professional students. Explanations for such variability in outcomes between institutions and healthcare professions have yet to be explored. The aim of our study was to understand what clinical learning, whilst under socially distanced restrictions, worked and why (or why not). Methods We conducted a realist evaluation of the undergraduate healthcare programmes at one UK university in 2020-21. The initial programme theories to be tested in this study were derived from discussions with programme leads about the changes they implemented due to the pandemic. Study participants were students and teaching faculty. Online interview transcripts were coded, identifying why the interventions in the programme had worked or not. This resulted in a set of ‘context-mechanism-outcome’ (CMO) statements about each intervention. The initial programme theories were refined as a result. Results and discussion 29 students and 22 faculty members participated. 18 CMO configurations were identified relating to clinical skills learning and 25 relating to clinical placements. Clinical skills learning was successful whether in person, remote or hybrid if it followed the steps of: demonstration – explanation – mental rehearsal – attempt with feedback. Where it didn’t work there was usually a lack of observation and corrective feedback. Placements were generally highly valued despite gaps in experience. Being useful on placements was felt to be good preparation for practice. Participant explanations from junior students about the value of various modes of induction to clinical workplace activity may also be relevant post-pandemic

Research priorities relating to the delivery of cardiovascular prevention and rehabilitation programmes: results of a modified Delphi process

Objective: The purpose of this British Association for Cardiovascular Prevention and Rehabilitation (BACPR) research priority setting project (PSP) was to identify a top 10 list of priority research questions for cardiovascular prevention and rehabilitation (CVPR). Methods: The PSP was facilitated by the BACPR clinical study group (CSG), which integrates as part of the British Heart Foundation Clinical Research Collaborative. Following a literature review to identify unanswered research questions, modified Delphi methods were used to engage CVPR-informed expert stakeholders, patients, partners and conference delegates in ranking the relevance of research questions during three rounds of an anonymous e-survey. In the first survey, unanswered questions from the literature review were ranked and respondents proposed additional questions. In the second survey, these new questions were ranked. Prioritised questions from surveys 1 and 2 were incorporated in a third/final e-survey used to identify the top 10 list. Results: From 459 responses across the global CVPR community, a final top 10 list of questions were distilled from an overall bank of 76 (61 from the current evidence base and a further 15 from respondents). These were grouped across five broad categories: access and remote delivery, exercise and physical activity, optimising programme outcomes, psychosocial health and impact of the pandemic. Conclusions: This PSP used a modified Delphi methodology to engage the international CVPR community to generate a top 10 list of research priorities within the field. These prioritised questions will directly inform future national and international CVPR research supported by the BACPR CSG