1
|
Platt A, Allan J, Leader C, Prescott-Clements L, McMeekin P. Preparing for practice, the effects of repeated immersive simulation on the knowledge and self-efficacy of undergraduate nursing students: A mixed methods study. Nurse Educ Pract 2024; 74:103866. [PMID: 38104396 DOI: 10.1016/j.nepr.2023.103866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/26/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
AIM The aim of this study was to compare the effects of two immersive simulation-based education instructional designs, immersive simulation with team deliberate practice and immersive repeated standard simulation, when delivered over the same time on the knowledge and self-efficacy of nursing students. BACKGROUND Implementing immersive simulation-based education is not without its resource challenges, making it prohibitive for simulation educators to include it in their curricula. Subsequently, there is a need to identify instructional designs that meet these challenges. DESIGN A two-stage mixed methods approach was used to compare the two instructional designs. METHODS In stage one, data were collected using questionnaires and differences estimated using analysis of covariance. In stage two, data were collected from two focus groups and analysed using a qualitative content analysis approach. Data were collected as part of a doctoral study completed in 2019 and was analysed for this study between 2022 and 2023. The justification for this study was that the identification of effective designs for immersive simulation remains a key research priority following the increase in allowable simulation hours by the Nursing and Midwifery Council. RESULTS In stage one, there was no statistical significance in the participant's knowledge or self-efficacy between the models. In stage two, four themes were identified: vulnerability, development of knowledge, development of self-efficacy and preparation for placement. In contrast to stage one, participants reported that the repeated nature of both designs reinforced their knowledge base increased their self-efficacy, reduced their anxiety levels, and helped them to prepare for placement. CONCLUSION The results inferred that both designs had a positive impact on the participants. Overall, participants reported that it helped them prepare for placements. Based on the findings, wherever possible, repeated immersive simulation-based education designs should be used and not a standalone immersive simulation-based education scenarios. If resources allow, this could be either a repeated scenario, or if there are resource constraints to use, over the same time, immersive simulation with team deliberate practice, or a similar model. Thus, giving a potential return on investment, one that supports simulation educators making those sensitive decisions regarding the inclusion of immersive simulation with team deliberate practice in their curriculum. Further research is needed into this area to ascertain the design features that maximise this impact and support a move away from standalone scenarios to an approach that uses repetitive immersive simulation.
Collapse
|
2
|
Reid M, Mason SJ, Platt A. 116.1: The principles of donor management and optimisation: An online education package making a real difference. Transplantation 2023; 107:5. [PMID: 37845849 DOI: 10.1097/01.tp.0000992976.38599.2c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Megan Reid
- Education and Professional Development Team, NHS Blood and Transplant, Glasgow, United Kingdom
| | - Sarah J Mason
- Education and Professional Development Team, NHS Blood and Transplant, Glasgow, United Kingdom
| | - Alan Platt
- Nursing, Midwifery and Health, Northumbria University Newcastle, Newcastle, United Kingdom
| |
Collapse
|
3
|
Mason S, Reid M, Platt A. 312.3: The use of evidence-based research and high-fidelity simulation to educate and empower the specialist nurse workforce within donor management and optimisation in the United Kingdom. Transplantation 2023; 107:75. [PMID: 37845962 DOI: 10.1097/01.tp.0000993428.73490.4a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Sarah Mason
- Education Professional Development Team, NHS Blood and Transplant, London, United Kingdom
| | - Megan Reid
- Education Professional Development Team, NHS Blood and Transplant, London, United Kingdom
| | - Alan Platt
- Nursing, Midwifery and Health, Northumbria University Newcastle, Newcastle, United Kingdom
| |
Collapse
|
4
|
Platt A, Liu CC, Gubler A, Naenni N, Thoma D, Schmidlin PR. In vitro evaluation of different protective techniques to reduce titanium particle contamination during implantoplasty. Clin Oral Investig 2023; 27:4205-4213. [PMID: 37140763 PMCID: PMC10415425 DOI: 10.1007/s00784-023-05037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Our aim is to study titanium remains in a bone model during standardized implantoplasty under different isolation and protective modalities. MATERIAL AND METHODS Forty implants were placed in artificial spongy bone blocks mimicking a horizontal bone loss and implant neck protrusion of 5 mm. Samples were randomly divided into four groups (n = 10), which were treated as follows: rubber dam (A), a dental adhesive paste (B), bone wax (C), and an unprotected positive control (D). Implantoplasty was performed using carbide and diamond burs under strict water cooling and standardized suction. After removal of the respective isolation materials, the bone blocks were thoroughly rinsed with tap water for 3 min and titanium chips were collected using a filter integrated in the model. The filter paper was removed and dissolved in 37% hydrochloric acid for 2 h at 120 °C and the titanium remnants were quantified using atomic absorption spectrometry. RESULTS None of the test groups were able to completely prevent titanium particle contamination. Rubber dam (691 ± 249 µg) and bone wax (516 ± 157 µg) were found to be significantly more protective than the positive control (2313 ± 747 µg) (p < 0.001) with respect to the amount of titanium particles that remained in the bone model after implantoplasty. The adhesive paste group (1863.5 ± 538 µg) was not significantly different from the positive control (p = 0.19). CONCLUSIONS Despite some limitations of the present study, titanium particles resulting from a standardized implantoplasty can be assumed to be significantly reduced when the tissues/bone were protected with rubber dam and bone wax, or a combination, depending on individual accessibility. CLINICAL RELEVANCE Tissue protective measures to reduce or avoid particle contamination during implantoplasty is possible and should be considered and further clinically assessed to avoid iatrogenic inflammatory reactions.
Collapse
Affiliation(s)
- A Platt
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - C C Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - A Gubler
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - N Naenni
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - D Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland.
| |
Collapse
|
5
|
Annesley SH, Platt A, Wade JA, Tomietto M. Grading practice as a strategy to improve proficiencies in undergraduate nurse education: Modelling key areas of competence. Nurse Educ Today 2023; 128:105890. [PMID: 37393651 DOI: 10.1016/j.nedt.2023.105890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND In undergraduate nursing grading practice is generally avoided as it is considered educationally flawed. OBJECTIVES To test an innovative online grading practice tool (GPT) in undergraduate nurse education. To model the determinants of the final practice grade in four areas of clinical competence and in one cohort analysis the relationship between final practice grade and each area of clinical competence and an OSCE grade. DESIGN A cross-sectional study. PARTICIPANTS A convenience sample of 782 nursing students from one Higher Education Institution in the North-East of England were included. The sample involved two sequential cohorts of final-year students with 391 students in each cohort. METHODS A specifically designed online grading practice tool (GPT) composed of thirty-six objectives equally divided across four areas of clinical competence. The GPT was applied to two consecutive student cohorts on completion of their final practice learning placement. RESULTS There was a statistically significant difference in the mean final practice grade between the two cohorts. In the overall sample, regression modelling showed that all four areas of student assessment contributed equally to the final grade. Analysis by cohort showed that in Cohort 1 clinical thinking and professionalism had the most influence on the final grade with person-centered care and patient safety most strongly impacting on the final grades of Cohort 2. In Cohort 2 there is no statistically significant correlation between final practice grade, each area of clinical competence and an OSCE grade. CONCLUSIONS Practice learning is fundamental to how students develop professional awareness and learn to nurse. Findings from a novel grading practice tool applied in undergraduate nursing reveal how effectively the tool works. Nurse educators must be responsive to the realities of learning in practice and explore new ways of assessing clinical competence.
Collapse
Affiliation(s)
- Sarah H Annesley
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne NE7 7XA, United Kingdom.
| | - Alan Platt
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne NE7 7XA, United Kingdom.
| | - James A Wade
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne NE7 7XA, United Kingdom.
| | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne NE7 7XA, United Kingdom.
| |
Collapse
|
6
|
Burford B, Grieg P, Kelleher M, Merriman C, Platt A, Richards E, Davidson N, Vance G. Interprofessional simulation as an enhancement of psychological fidelity: A focus group study of medical and nursing students. Health Sci Rep 2023; 6:e1237. [PMID: 37152225 PMCID: PMC10154877 DOI: 10.1002/hsr2.1237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/21/2023] [Accepted: 04/16/2023] [Indexed: 05/09/2023] Open
Abstract
Background and Aims Interprofessional simulation has the potential to enhance the perceived realism of clinical simulation in the education of different healthcare professionals. This study considers how the inclusion of more than one profession in clinical simulation contributes to this psychological fidelity, defined as the subjective perception of the realism of a simulation, and the cues identified by medical and nursing students. Methods Eight focus groups were carried out with 27 medical and 18 nursing students in Newcastle and Oxford, UK. These were carried out immediately after students' participation in simulation sessions consisting of three acute scenarios. Focus group discussions encompassed perceptions of the realism of the simulation and of participants' own and other professional groups. Thematic analysis was carried out on transcripts. Results The analysis identified features of psychological fidelity that were influenced by the interprofessional element of the simulation. These included overall impressions of realism, and the perceived roles and expectations of doctors and nurses within the simulation. In particular, the presence of the other professional group afforded a more authentic response. Other features varied with the viewpoint of the student groups, in particular the realism of the patient manikin, which held lower psychological fidelity for the nursing students, because it did not allow them to fulfill their perceived role of delivering holistic, relational care. Conclusion Recognizing "psychological fidelity" as a subjective response to simulation allows greater consideration of the limitations of fidelity as a designed or engineered property of a simulation. While interprofessional involvement directly enhances psychological fidelity in some ways, potential differences in the views of students from different professional groups should be considered when implementing interprofessional simulation.
Collapse
Affiliation(s)
- Bryan Burford
- School of MedicineNewcastle UniversityNewcastle upon TyneUK
| | - Paul Grieg
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Mike Kelleher
- Department of Nursing, Midwifery & HealthNorthumbria UniversityNewcastle upon TyneUK
| | - Clair Merriman
- Oxford Institute of Nursing, Midwifery, and Allied Health ResearchOxford Brookes UniversityOxfordUK
| | - Alan Platt
- Department of Nursing, Midwifery & HealthNorthumbria UniversityNewcastle upon TyneUK
| | | | - Neil Davidson
- School of MedicineNewcastle UniversityNewcastle upon TyneUK
| | - Gill Vance
- School of MedicineNewcastle UniversityNewcastle upon TyneUK
| |
Collapse
|
7
|
Herberger S, Hajak G, Platt A, Penzel T, Fietze I, Ruether E. Somnologics - Medicines for the Treatment of Sleep Disorders. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Van Laar JM, Lei A, Safy-Khan M, Almquist J, Astbury C, Belvisi M, Platt A, Prothon S, Samuelsson S, Svanberg P, Keen C. POS0089 AZD9567 VERSUS PREDNISOLONE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: A PHASE 2A, RANDOMISED, DOUBLE-BLIND, PARALLEL-GROUP EFFICACY AND SAFETY STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Oral corticosteroids such as prednisolone are potent anti-inflammatory drugs but their use is limited by side effects caused by unwanted actions on the glucocorticoid receptor (GR), such as increased insulin resistance, and off-target actions on the mineralocorticoid receptor (MR) that disrupt electrolyte balance and increase water retention. AZD9567 is an oral, selective, non-steroidal glucocorticoid receptor modulator being developed to treat inflammatory diseases. Pre-clinical and phase 1 clinical data indicate that AZD9567 is the first GR modulator with an improved efficacy–dysglycaemic side effect profile versus prednisolone.Objectives:To compare the efficacy, safety and tolerability of AZD9567 with prednisolone in patients with active rheumatoid arthritis (RA), at doses with predicted equivalent anti-inflammatory activity.Methods:In this phase 2a, randomised, double-blind, parallel-group, multicentre study in RA patients with DAS28-CRP ≥ 3.2 despite stable treatment with conventional disease-modifying anti-rheumatic therapies (NCT03368235), patients were randomised 1:1 to AZD9567 40 mg or prednisolone 20 mg orally once daily for 14 days. The primary endpoint was change from baseline in DAS28-CRP at day 15. Secondary outcomes included components of DAS28-CRP, TJC68, SJC66, ACR response (ACR20, ACR50, ACR70) and safety outcomes, including serum electrolytes.Results:All 21 randomised patients (AZD9567, n = 11; prednisolone, n = 10) completed the study. There was a slight imbalance between the treatment groups at baseline, with higher age (mean ± SD: 64.5 ± 8.4 vs 55.5 ± 13.6 years), more women (8 vs 5) and greater disease severity (DAS28-CRP, mean ± SD: 5.26 ± 0.98 vs 4.90 ± 0.74) in the AZD9567 group versus the prednisolone group. There was no statistically significant or clinically meaningful (i.e. > 1.2) difference in change from baseline to day 15 in DAS28-CRP between AZD9567 and prednisolone, although this was numerically lower with AZD9567 (Table 1). Similar results were observed for TJC68, SJC66, CRP and GH (Table 1). The proportions of patients achieving ACR20, 50 and 70 response criteria were similar in both groups, albeit numerically lower with AZD9567. Similar numbers of patients in each group reported treatment-emergent adverse events (AZD9567, n = 10, prednisolone, n = 9); most were mild in severity. One serious adverse event, suicidal depression, was reported after completing AZD9567 treatment. Morning fasting serum sodium/potassium ratio at day 15 was not altered with AZD9567 but was increased from baseline with prednisolone (Figure 1).Conclusion:AZD9567 40 mg had a similar efficacy profile to prednisolone 20 mg in patients with active RA. Both drugs were well tolerated, with no new safety signals. Unlike prednisolone, AZD9567 had no effect on serum sodium/potassium ratio, suggesting selectivity of AZD9567 for the GR over the MR. These results support further trials of AZD9567 in patients with inflammatory disease.Table 1.Change from baseline to day 15 in clinical disease activity measures.AZD9567 (n = 11)Prednisolone (n = 10)Comparison(AZD9567 – prednisolone)LSM CFB (SE)95% CILSM CFB (SE)95% CILSMD (SE)95% CIp valueDAS28−CRP score−1.93 (0.35)−2.66, −1.21−2.40 (0.34)−3.11, −1.700.47 (0.46)−0.49, 1.430.315TJC28 score−6.12 (1.25)−8.76, −3.49−6.07 (1.21)−8.61, −3.52−0.05 (1.60)−3.43, 3.320.973SJC28 score−5.14 (0.65)−6.51, −3.76−5.40 (0.63)−6.73, −4.080.26 (0.84)−1.50, 2.030.757GH score−27.7 (7.3)−42.8, −12.5−37.4 (7.1)−52.3, −22.69.8 (9.7)−10.5, 30.10.325CRP, mg/L−10.8 (2.4)−15.9, −5.8−15.6 (2.5)−20.9, −10.34.8 (3.5)−2.5, 12.00.187TJC68 score−9.02 (2.46)−14.21, −3.82−7.90 (2.36)−12.88, −2.91−1.12 (3.12)−7.69, 5.460.724SJC66 score−6.24 (0.89)−8.13, −4.36−6.66 (0.86)−8.48, −4.850.42 (1.14)−1.98, 2.810.717CFB, change from baseline; CRP, C-reactive protein; DAS28, 28-joint disease activity score; GH, global health; LSM(D), least-squares mean (difference); SJC, swollen joint count; TJC, tender joint count.Acknowledgements:Medical writing support was provided by Richard Claes PhD of PharmaGenesis London, London, UK, funded by AstraZeneca, Gothenburg, Sweden in accordance with Good Publication Practice 3 (GPP3) guidelines (http://www.ismpp.org/gpp3).This study was funded by AstraZeneca. AZD9567 is an investigational medical product with no approved indication.Disclosure of Interests:Jacob M. van Laar Consultant of: Honoraria from - Abbvie, Arxx Tx, Galapagos, Gesyntha, Leadiant, Magenta, Roche, Sanofi Genzyme, Grant/research support from: AstraZeneca, Pfizer, Roche, Alejhandra Lei Shareholder of: AstraZeneca., Grant/research support from: Boehringer Ingelheim in 1998, Bristol-Myers Squibb in 1999, Employee of: AstraZeneca. Past employee of Almirall, Grünenthal, Boehringer Ingelheim, CESIF Pharma, Mary Safy-Khan Grant/research support from: Student grant from AstraZeneca 2015-2018., Joachim Almquist Shareholder of: AstraZeneca, Consultant of: AstraZeneca., Employee of: AstraZeneca., Carol Astbury Shareholder of: AstraZeneca., Employee of: AstraZeneca., Maria Belvisi Shareholder of: AstraZeneca., Grant/research support from: AstraZeneca and Chiesi, Employee of: AstraZeneca., Adam Platt Shareholder of: AstraZeneca., Employee of: AstraZeneca., Susanne Prothon Shareholder of: AstraZeneca., Employee of: AstaZeneca., Sara Samuelsson Shareholder of: AstraZeneca, Employee of: AstraZeneca, Petter Svanberg Employee of: AstraZeneca, Christina Keen Shareholder of: AstraZeneca., Employee of: AstraZeneca.
Collapse
|
9
|
Platt A, McMeekin P, Prescott-Clements L. Effects of the Simulation Using Team Deliberate Practice (Sim-TDP) model on
the performance of undergraduate nursing students. BMJ Simul Technol Enhanc Learn 2020; 7:66-74. [DOI: 10.1136/bmjstel-2019-000520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 11/04/2022]
Abstract
Background
The use of simulation has grown in prominence, but variation in the
quality of provision has been reported, leading to calls for further research
into the most effective instructional designs. Simulation Using Team Deliberate
Practice (Sim-TDP) was developed in response. It combines the principles of
simulation with deliberate practice, therefore, providing participants with
opportunities to work towards well-defined goals, rehearse skills and reflect
on performance whilst receiving expert feedback. This study aimed to compare
the effects of Sim-TDP, versus the use of traditional simulation, on the
performance of second year adult nursing students.
Methods
Using a longitudinal quasi-experimental design, the effects of the two
approaches were compared over a 1-year period. Sixteen groups, each containing
an average of six participants, were randomised into an intervention arm (n=8)
or comparison arm (n=8). Data collection took place at 3 monthly intervals, at
which point the performance and time to complete the scenario objectives/tasks,
as a team, were recorded and analysed using a validated performance
tool.
Results
The independent t-tests, comparing the performance of the groups, did not
demonstrate any notable differences during the three phases. However, in phase
1, the independent t-tests suggested an improvement in the Sim-TDP
participants’ time spent on task
(t(14) = 5.12, p<0.001),
with a mean difference of 7.22 min. The mixed analysis of covariance inferred
that the use of the Sim-TDP led to an improvement, over time, in the
participants’ performance (F(1, 5) = 12.91, p=0.016), and
thus, an association between Sim-TDP and the enhanced performance of
participants.
Conclusion
The results suggest that Sim-TDP, potentially, optimised participant
performance, while maximising the use of Simulation-based education (SBE)
resources, such as simulation facilities and equipment. The model could be of
practical benefit to nurse educators wishing to integrate SBE into their
programmes.
Collapse
|
10
|
Burford B, Greig P, Kelleher M, Merriman C, Platt A, Richards E, Davidson N, Vance G. Effects of a single interprofessional simulation session on medical and nursing students' attitudes toward interprofessional learning and professional identity: a questionnaire study. BMC Med Educ 2020; 20:65. [PMID: 32131805 PMCID: PMC7057493 DOI: 10.1186/s12909-020-1971-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/18/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Participation in simulation-based interprofessional education (sim-IPE) may affect students' attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the 'fit' of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK. METHOD Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured. Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures. RESULTS A total of 194 medical and 266 nursing students completed questionnaires. A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site. Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students. CONCLUSIONS Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace. Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect.
Collapse
Affiliation(s)
- Bryan Burford
- School of Medical Education, Newcastle University, Cookson Building, Newcastle upon Tyne, NE2 1HH, UK.
| | - Paul Greig
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Mike Kelleher
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | - Clair Merriman
- Department of Nursing, Oxford Brooks University, Oxford, UK
| | - Alan Platt
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - Neil Davidson
- School of Medical Education, Newcastle University, Cookson Building, Newcastle upon Tyne, NE2 1HH, UK
| | - Gill Vance
- School of Medical Education, Newcastle University, Cookson Building, Newcastle upon Tyne, NE2 1HH, UK
| |
Collapse
|
11
|
Pennington M, Ring H, Howlett J, Smith C, Redley M, Murphy C, Hook R, Platt A, Gilbert N, Jones E, Kelly J, Pullen A, Mander A, Donaldson C, Rowe S, Wason J, Irvine F. The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study. J Intellect Disabil Res 2019; 63:1391-1400. [PMID: 31397022 PMCID: PMC7613974 DOI: 10.1111/jir.12679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability (ID) offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of ID nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs. METHOD Across the United Kingdom, eight sites randomly allocated to the intervention recruited 184 participants and nine sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after 6 months. Total costs at 6 months were compared from the perspective of health and social services and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data were imputed using multiple imputation. Uncertainty was quantified by bootstrapping. RESULTS The intervention was associated with lower per participant costs from a health and social services perspective of -£357 (2014/2015 GBP) (95% confidence interval -£986, £294) and from a societal perspective of -£631 (95% confidence interval -£1473, £181). Results were not sensitive to the exclusion of accommodation costs. CONCLUSIONS Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and ID and may reduce costs.
Collapse
Affiliation(s)
- M Pennington
- Department of Health Services and Population Research, King's Health Economics, PO24, David Goldberg Centre, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - H Ring
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England, Cambridge, UK
| | - J Howlett
- MRC Biostatistics Unit, University of Cambridge, Institute of Public Health, Cambridge, UK
| | - C Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - M Redley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England, Cambridge, UK
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - C Murphy
- King's Clinical Trials Unit, PO64 Institute of Psychiatry, King's College London, London, UK
| | - R Hook
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - A Platt
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - N Gilbert
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - E Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - J Kelly
- King's Clinical Trials Unit, PO64 Institute of Psychiatry, King's College London, London, UK
| | - A Pullen
- Epilepsy Action, New Antsey House, Leeds, UK
- NHS Leeds West Clinical Commissioning Group, Leeds, UK
| | - A Mander
- NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England, Cambridge, UK
| | - C Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - S Rowe
- Finance and Contracts, NHS Wakefield Clinical Commissioning Group, Wakefield, UK
| | - J Wason
- MRC Biostatistics Unit, University of Cambridge, Institute of Public Health, Cambridge, UK
| | - F Irvine
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
12
|
Blair JPM, Bager C, Platt A, Karsdal M, Bay-Jensen AC. Identification of pathological RA endotypes using blood-based biomarkers reflecting tissue metabolism. A retrospective and explorative analysis of two phase III RA studies. PLoS One 2019; 14:e0219980. [PMID: 31339920 PMCID: PMC6655687 DOI: 10.1371/journal.pone.0219980] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 07/05/2019] [Indexed: 12/31/2022] Open
Abstract
There is an increasing demand for accurate endotyping of patients according to their pathogenesis to allow more targeted treatment. We explore a combination of blood-based joint tissue metabolites (neoepitopes) to enable patient clustering through distinct disease profiles. We analysed data from two RA studies (LITHE (N = 574, follow-up 24 and 52 weeks), OSKIRA-1 (N = 131, follow-up 24 weeks)). Two osteoarthritis (OA) studies (SMC01 (N = 447), SMC02 (N = 81)) were included as non-RA comparators. Specific tissue-derived neoepitopes measured at baseline, included: C2M (cartilage degradation); CTX-I and PINP (bone turnover); C1M and C3M (interstitial matrix degradation); CRPM (CRP metabolite) and VICM (macrophage activity). Clustering was performed to identify putative endotypes. We identified five clusters (A-E). Clusters A and B were characterized by generally higher levels of biomarkers than other clusters, except VICM which was significantly higher in cluster B than in cluster A (p<0.001). Biomarker levels in Cluster C were all close to the median, whilst Cluster D was characterised by low levels of all biomarkers. Cluster E also had low levels of most biomarkers, but with significantly higher levels of CTX-I compared to cluster D. There was a significant difference in ΔSHP score observed at 52 weeks (p<0.05). We describe putative RA endotypes based on biomarkers reflecting joint tissue metabolism. These endotypes differ in their underlining pathogenesis, and may in the future have utility for patient treatment selection.
Collapse
Affiliation(s)
- J. P. M. Blair
- ProScion, Herlev, Denmark
- University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- * E-mail:
| | | | - A. Platt
- Target & Translational Science, Respiratory, Inflammation and Autoimmunity (RIA), IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - M. Karsdal
- Rheumatology, Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - A. -C. Bay-Jensen
- Rheumatology, Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| |
Collapse
|
13
|
Porteous D, Morgan D, Solomon J, Platt A, Allan J, Shao CHJ, Conner T. Global citizens. Br J Nurs 2019; 28:574-577. [PMID: 31070961 DOI: 10.12968/bjon.2019.28.9.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Nurses and nursing students from the UK and overseas are learning in each other's countries.
Collapse
Affiliation(s)
| | | | - Jennifer Solomon
- Director, Nursing and Allied Health Sciences, St George's University, Grenada
| | - Alan Platt
- Programme leader, Northumbria University
| | | | - Chun Hua Joy Shao
- Programme Leader, MSc Nursing/Nursing Leadership and BSc (Hons) Nursing Science, Northumbria University, Newcastle-upon-Tyne
| | | |
Collapse
|
14
|
Siebuhr A, Platt A, Karsdal M, Bay-Jensen AC. SAT0053 C1m Is A Serological Biomarker for Identification of Structural Progressors in Rheumatoid Arthritis; Validation in 3 Phase III Clinical Trials. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
15
|
Gudmann N, Platt A, Karsdal M, Bay-Jensen A. FRI0089 C4M – A Blood-Based Biomarker – Is An Objective Marker of Disease Activity and Radiographic Status: Replication and Validation or Previous Findings in The Oskira Rheumatoid Arthritis Studies. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
16
|
Abstract
Policies supporting breastfeeding vary by state, but little is known about the geographical aspects of this variation. This study describes state breastfeeding licensing and administrative regulations targeting child care settings, compares regulations with national standards, and examines the spatial patterning and clustering of these regulations throughout the United States (US). We compared regulations for child care centers (centers) and family child care homes (homes) with national standards for: (1) general breastfeeding support; (2) designated place for breastfeeding; (3) no solids before infants are four months of age; and (4) no formula for breastfed infants without parent permission. We scored state regulations as 0 = standard not addressed, 1 = standard partially addressed, and 2 = standard fully addressed. We considered each regulation individually, and also summed scores to provide an overall rating of regulations by state. We mapped regulations using geographic information systems technology, and explored overall and local spatial autocorrelation using global and local variants of Moran's I. Five states had regulations for centers and two for homes that addressed all four standards. Mean regulation scores were 0.35, 0.20, 0.98, 0.74 for centers, and 0.17, 0.15, 0.79, 0.58 for homes. Local Moran's I revealed that New York and Pennsylvania had substantially stronger regulations than their adjacent states, while Florida had weaker regulations than its neighbors. Overall, few states had regulations that met breastfeeding standards. We identified some patterns of spatial correlation, suggesting avenues for future research to better understand distributions of regulations across the US.
Collapse
Affiliation(s)
- S. E. Benjamin Neelon
- Department of Community and Family Medicine, Duke University Medical Center and Duke Global Health Institute, 2200 W Main Street, DUMC 104006, Durham, NC 27705 USA
- Duke Global Health Institute, Trent Hall, 310 Trent Drive, Durham, NC 27710 USA
- UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Box 296, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - D. T. Duncan
- Department of Population Health, New York University School of Medicine, New York, NY 10016 USA
| | - T. Burgoine
- UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Box 296, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - M. Mayhew
- Department of Community and Family Medicine, Duke University Medical Center and Duke Global Health Institute, 2200 W Main Street, DUMC 104006, Durham, NC 27705 USA
| | - A. Platt
- Duke Global Health Institute, Trent Hall, 310 Trent Drive, Durham, NC 27710 USA
| |
Collapse
|
17
|
Bay-Jensen AC, Platt A, Siebuhr A, Christiansen C, Karsdal M. THU0232 Serological Biomarkers of Joint Turnover PREDICT Early Responders to TOCILIZUMAB Intervention. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
18
|
Nicholson S, Platt A. Management of traumatic digital amputations. Br J Hosp Med (Lond) 2014; 75:C50-2, C54. [PMID: 24795990 DOI: 10.12968/hmed.2014.75.sup4.c50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Bay-Jensen A, Byrjalsen I, Kenwright A, Platt A, Karsdal M. OP0127 Identification of serological biomarker profiles associated with early response to tocilizumab in rheumatoid arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.1810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
20
|
Alinier G, Platt A. International overview of high-level simulation education initiatives in relation to critical care. Nurs Crit Care 2013; 19:42-9. [PMID: 24400608 DOI: 10.1111/nicc.12030] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 03/19/2013] [Accepted: 04/26/2013] [Indexed: 12/26/2022]
Abstract
The use of simulation in health care education has become very topical across all professions and specialties in order to improve patient safety and quality of care. In the last decade, the adoption of more realistic simulation-based teaching methodologies, which serves as a bridge between the acquisition and application of clinical skills, knowledge, and attributes, has been accompanied by the development of a multitude of international and national simulation societies. These serve as important exchange fora for educators, clinicians, researchers, and engineers who desire to learn and share their experience and knowledge around simulation-based education. Several countries have derived their own strategy in order to promote the use of such training methodology. Current key national strategies will be presented in this paper alongside a discussion of their expected impact. Various approaches have been adopted and each has their own place and the potential to be adopted by other nations depending on their political, economic or even geographic context. Within the critical care arena, simulation has generated considerable interest and there is a growing evidence base for its use as a learning and teaching strategy within this environment. A number of critical care-related associations and societies are now recognizing simulation as an appropriate pedagogical approach and acknowledging its potential to improve patient care and clinical outcomes. Its implementation should be carefully considered to ensure that developments are based on current best educational practice to maximize the efficiency of these educational interventions.
Collapse
Affiliation(s)
- Guillaume Alinier
- Professor G Alinier, PhD, MPhys, PGCert, CPhys, MInstP, MIPEM, SFHEA, School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK; Simulation Training and Research Manager, Hamad Medical Corporation Ambulance Service, Doha, Qatar
| | | |
Collapse
|
21
|
Karsdal MA, Siebuhr AS, Leeming DJ, Byrjalsen I, Christiansen C, Platt A, Bay-Jensen AC. FRI0084 Structural progressors in rheumatoid arthritis identified by serology – identification of the patients in most need of intensive treatment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
22
|
Affiliation(s)
- John Stephens
- School of Health, Community and Education Studies, Northumbria University, UK
| | | | - Alan Platt
- School of Health, Community and Education Studies, Northumbria University, UK
| |
Collapse
|
23
|
Abstract
One of the fundamental problems facing providers and commissioners of health services is how to maintain the skills and knowledge of the workforce during the initial development and implementation of home care services. This small-scale project sought to ascertain if it was possible to use human patient simulation scenarios to educate community nurses about how to recognize when care at home is appropriate and when it is not. A series of scenarios were developed and delivered to small groups of community nursing staff. A total of 18 qualified nurses took part in the project. Participants were asked to report their level of confidence in the diagnosis, management and recognition of patient deterioration for each of the scenarios prior to and after the session. The results show increased confidence across all participants in each of the scenarios.
Collapse
Affiliation(s)
- John Unsworth
- School of Health, Community & Education Studies, Northumbria University.
| | | | | |
Collapse
|
24
|
Abstract
This paper provides an overview of the implementation and evaluation of the critical care assistant (CCA) role within a large teaching trust. Nine CCAs were employed as a pilot across six critical care units. A multistakeholder evaluation was performed to establish the impact of the new role on the critical care team and the contribution to patient care. The evaluation was undertaken over 6 months and used questionnaire format and focus group interviews. The results of the evaluation were overall mixed with some improvements noted especially within high-dependency care where the introduction of the role eased some of the workload pressures on qualified staff and allowed nurses to focus on the more dependent patients. A structured education and training programme supported by the National Vocational Qualification level 3 assessment strategy helped to prepare the CCAs theoretically for the extension in their role; however, difficulties were experienced with the appropriate allocation of tasks and general communication with nursing staff. The perceptions of both patients and relatives were sought and evaluated positively as they were satisfied with the standard of care received and were comfortable with a CCA providing their care, which supports the future development of the role.
Collapse
Affiliation(s)
- Anita McGuire
- Critical Care Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | | | | | | | | | | |
Collapse
|
25
|
|
26
|
Chiam R, Smid L, Kydd JH, Smith KC, Platt A, Davis-Poynter NJ. Use of polarised equine endothelial cell cultures and an in vitro thrombosis model for potential characterisation of EHV-1 strain variation. Vet Microbiol 2005; 113:243-9. [PMID: 16338104 DOI: 10.1016/j.vetmic.2005.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Equine herpesvirus-1 (EHV-1) is responsible for respiratory disease and abortion in pregnant mares. Some high virulence isolates of EHV-1 also cause neurological disease. The pathogenesis of both abortion and neurological disease relates in part, to thrombus formation occurring in the pregnant uterus and central nervous system. The differences in disease outcome may relate to differing abilities of high and low virulence EHV-1 isolates to cause cell-associated viraemia, infect endothelial cells and cause thrombosis at sites distant from the respiratory tract. This study attempted to identify in vitro assays, which could be used to characterise the interaction between these isolates, equine endothelial cells and clotting factors. No significant difference was found between the growth kinetics of high and low virulence isolates of EHV-1 in polarised endothelial cells. For both isolates, virus was released preferentially from the apical surface of the polarised cells. The functional effects of viral infection on endothelial cells, with reference to virally-induced thrombosis were then investigated. Endothelial cells were grown on microcarrier beads, infected with EHV-1 and assayed for procoagulant activity. No significant difference in clotting time was observed between mock and EHV-1 infected endothelial cells in microcarrier cultures. Thus the degree of thrombosis may reflect a more complex interaction between endothelial cells, circulating leucocytes and other factors in the microenvironment.
Collapse
Affiliation(s)
- R Chiam
- Animal Health Trust, Centre for Preventive Medicine, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
| | | | | | | | | | | |
Collapse
|
27
|
Puleston J, Cooper M, Murch S, Bid K, Makh S, Ashwood P, Bingham AH, Green H, Moss P, Dhillon A, Morris R, Strobel S, Gelinas R, Pounder RE, Platt A. A distinct subset of chemokines dominates the mucosal chemokine response in inflammatory bowel disease. Aliment Pharmacol Ther 2005; 21:109-20. [PMID: 15679760 DOI: 10.1111/j.1365-2036.2004.02262.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is characterised by intense mucosal recruitment of activated leukocytes. Chemokines determine inflammatory leukocyte recruitment and retention. AIM To compare expression of the entire chemokine family within colonic mucosa from IBD patients and uninflamed controls. METHODS A microarray of cDNAs, representing every member of this superfamily and their cognate receptors, was hybridised with probes derived from colonoscopic biopsies. RESULTS A distinct subset of chemokines, consisting of CXCLs 1-3 and 8 and CCL20, was upregulated in active colonic IBD, compared with uninflamed areas or tissue from controls. Increased expression of their cognate receptors, CXCR1, CXCR2 and CCR6, was confirmed by quantitative PCR and immunohistochemistry. An identical chemokine response was induced in Caco-2 cells by stimulation with interleukin (IL)-1beta, but not tumour necrosis factor-alpha (TNF-alpha). By contrast, IL-1beta and TNF-alpha were synergistic in an HT29 cell line and primary keratinocytes. CONCLUSIONS IL-1beta and TNF-alpha appear to be the pivotal mediators of a previously unidentified coordinated epithelial chemokine response that dominates the mucosal chemokine environment in inflamed IBD tissue.
Collapse
Affiliation(s)
- J Puleston
- Centre for Gastroenterology, Royal Free Hospital, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Sillitoe AT, Platt A. The Z-plasty simulator. Ann R Coll Surg Engl 2004; 86:304-5. [PMID: 15329985 PMCID: PMC1964195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Affiliation(s)
- A T Sillitoe
- Department of Plastic and Reconstructive Surgery, Castle Hill Hospital, Cottingham, Hull HU16 5JQ, UK
| | | |
Collapse
|
29
|
Dijk WV, Kiers KA, Nogami Y, Platt A, Spyksma K. Quantum mechanical and semi-classical treatment of quantum excitations due to the passage of a particle. ACTA ACUST UNITED AC 2003. [DOI: 10.1088/0305-4470/36/20/318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
30
|
Abstract
BACKGROUND/AIMS The p73 gene encodes a protein that shares structural and functional homology with the p53 gene product. The highest degree of homology is in the DNA binding domain, which is the region of p53 that is most frequently mutated in cancer. In contrast to p53 there is little evidence that p73 acts as a classic tumour suppressor gene. Because of the similarities between the p53 and p73 genes and the high frequency of mutation of p53, this study was designed to investigate the p73 gene in patients with gastric adenocarcinoma. METHODS The mutational status of the p73 gene was investigated in a series of 13 cases of gastric adenocarcinoma from the antro-pyloric region and the gastro-oesophageal junction, using the polymerase chain reaction, single strand conformational polymorphism, and direct DNA sequencing. RESULTS A glutamine to arginine mutation was detected in exon 5 of the p73 gene in a case of adenocarcinoma at the gastro-oesophageal junction. CONCLUSION Although limited to a small series of cases, these results suggest that p73 may have a potential pathogenetic role in this tumour.
Collapse
Affiliation(s)
- E Pilozzi
- Department of Experimental Medicine and Pathology, II Facoltà di Medicina e Chirurgia, Ospedale Sant'Andrea, Università "La Sapienza", Roma, Italy.
| | | | | | | | | |
Collapse
|
31
|
Abstract
JCAHO's new pain standards promise better pain assessment, management, and outcomes for patients. A new technology can help nurses boost documentation and meet the increased demand on their time.
Collapse
Affiliation(s)
- A Platt
- Georgia Comprehensive Sickle Cell Center, Grady Health System, Emory University School of Medicine, Atlanta, Ga., USA
| | | |
Collapse
|
32
|
Bahia H, Platt A, Baguley P, Ramakrishnan V. Cervical lymphadenopathy as metastases from a scalp secondary: a 'double metastasis'. Eur J Surg Oncol 2001; 27:119-21. [PMID: 11237503 DOI: 10.1053/ejso.2000.1022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
33
|
Abstract
The case is reported of a 23 year old male body builder who was involved in a road traffic accident after taking anabolic steroids. The resulting trauma caused a severe life threatening acute multicompartment syndrome resulting in the need for urgent multiple fasciotomies.
Collapse
Affiliation(s)
- H Bahia
- Department of Plastic Surgery, Kingston General Hospital, Hull, United Kindgom
| | | | | | | |
Collapse
|
34
|
Platt A, Ross HC, Hankin S, Reece RJ. The insertion of two amino acids into a transcriptional inducer converts it into a galactokinase. Proc Natl Acad Sci U S A 2000; 97:3154-9. [PMID: 10737789 PMCID: PMC16208 DOI: 10.1073/pnas.97.7.3154] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The transcriptional induction of the GAL genes of Saccharomyces cerevisiae occurs when galactose and ATP interact with Gal3p. This protein-small molecule complex associates with Gal80p to relieve its inhibitory effect on the transcriptional activator Gal4p. Gal3p shares a high degree of sequence homology to galactokinase, Gal1p, but does not itself possess galactokinase activity. By constructing chimeric proteins in which regions of the GAL1 gene are inserted into the GAL3 coding sequence, we have been able to impart galactokinase activity upon Gal3p as judged in vivo and in vitro. Remarkably, the insertion of just two amino acids from Gal1p into the corresponding region of Gal3p confers galactokinase activity onto the resultant protein. The chimeric protein, termed Gal3p+SA, retains its ability to efficiently induce the GAL genes. Kinetic analysis of Gal3p+SA reveals that the K(m) for galactose is similar to that of Gal1p, but the K(m) for ATP is increased. The chimeric enzyme was found to have a decreased turnover number in comparison to Gal1p. These results are discussed in terms of both the mechanism of galactokinase function and that of transcriptional induction.
Collapse
Affiliation(s)
- A Platt
- School of Biological Sciences, The University of Manchester, 2.205 Stopford Building, Oxford Road, Manchester M13 9PT, United Kingdom
| | | | | | | |
Collapse
|
35
|
Abstract
Saccharomyces cerevisiae responds to galactose as the sole source of carbon by activating the GAL genes encoding the enzymes of the Leloir pathway. Here, we show in vitro that the switch from repressed to activated gene expression involves the interplay of three proteins [an activator (Gal4p), a repressor (Gal80p) and an inducer (Gal3p)] and two small molecules (galactose and ATP). We also show that the galactose- and ATP-dependent interaction between Gal3p and Gal80p occurs without disruption of the Gal80p-Gal4p interaction. Thus, Gal3p-mediated activation of transcription occurs via the formation of a tripartite protein complex.
Collapse
Affiliation(s)
- A Platt
- School of Biological Sciences, The University of Manchester, 2.205 Stopford Building, Oxford Road, Manchester M13 9PT, UK
| | | |
Collapse
|
36
|
Abstract
Activators of RNA polymerase II transcription possess distinct and separable DNA-binding and transcriptional activation domains. They are thought to function by binding to specific sites on DNA and interacting with proteins (transcription factors) binding near to the transcriptional start site of a gene. The ability of these proteins to activate transcription is a highly regulated process, with activation only occurring under specific conditions to ensure proper timing and levels of target gene expression. Such regulation modulates the ability of transcription factors either to bind DNA or to interact with the transcriptional machinery. Here we discuss recent advances in our understanding of these mechanisms of transcriptional regulation in yeast.
Collapse
Affiliation(s)
- R J Reece
- School of Biological Sciences, University of Manchester, UK.
| | | |
Collapse
|
37
|
Platt A, Langdon T, Arst HN, Kirk D, Tollervey D, Sanchez JM, Caddick MX. Nitrogen metabolite signalling involves the C-terminus and the GATA domain of the Aspergillus transcription factor AREA and the 3' untranslated region of its mRNA. EMBO J 1996; 15:2791-801. [PMID: 8654376 PMCID: PMC450215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
AREA is a GATA transcription factor which mediates nitrogen metabolite repression in Aspergillus nidulans in response to intracellular glutamine levels. We have identified and localized three elements important to modulation of AREA function: a region of 13 residues within the DNA-binding GATA domain which forms a putative extended loop structure, the 12 C-terminal residues, and sequences within a 218 nucleotide region of the 3' UTR. The 12 C-terminal residues are also required for transcriptional activation at a subset of loci under areA control. Specific deletions within the 3' UTR and the C-terminus cause similar levels of derepression and the mutations are additive, implicating two principal signal transduction pathways. The contribution of the 3' UTR to AREA modulation is effected at the level of transcript stability such that the areA mRNA is at least five times more stable under nitrogen-derepressing conditions than it is under repressing growth conditions.
Collapse
Affiliation(s)
- A Platt
- Department of Genetics and Microbiology, Donnan Laboratories, University of Liverpool, Liverpool, UK
| | | | | | | | | | | | | |
Collapse
|
38
|
Platt A, Langdon T, Arst HN, Kirk D, Tollervey D, Sanchez JM, Caddick MX. Nitrogen metabolite signalling involves the C-terminus and the GATA domain of the Aspergillus transcription factor AREA and the 3′ untranslated region of its mRNA. EMBO J 1996. [DOI: 10.1002/j.1460-2075.1996.tb00639.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
39
|
Platt A, Ravagnani A, Arst H, Kirk D, Langdon T, Caddick MX. Mutational analysis of the C-terminal region of AREA, the transcription factor mediating nitrogen metabolite repression in Aspergillus nidulans. Mol Gen Genet 1996; 250:106-14. [PMID: 8569680 DOI: 10.1007/bf02191830] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In Aspergillus nidulans the positive-acting, wide domain regulatory gene areA mediates nitrogen metabolite repression. Previous analysis demonstrated that the C-terminal 153 residues of the areA product (AREA) are inessential for at least partial expression of most genes subject to regulation by areA. Paradoxically, areAr2, a -1 frameshift replacing the wild-type 122 C-terminal residues with a mutant peptide of 117 amino acids, leads to general loss of function. To determine the basis for the areAr2 mutant phenotype, and as a means of delineating functional domains within the C-terminal region of AREA, we have selected and characterised areAr2 revertants. Deletion analysis, utilising direct gene replacement, extended this analysis. A mutant areA product truncated immediately after the last residue of the highly conserved GATA (DNA-binding) domain retains partial function. The areAr2 product retains some function with respect to the expression of uaZ (encoding urate oxidase) and the mutant allele is partially dominant with respect to nitrate reductase levels. Consistent with the areAr2 product having a debilitating biological activity, we have demonstrated that a polypeptide containing both the wild-type DNA-binding domain and the mutant C-terminus of AREA2 is able to bind DNA in vitro but no longer shows specificity for GATA sequences.
Collapse
Affiliation(s)
- A Platt
- Department of Genetics and Microbiology, Donnan Laboratories, University of Liverpool, UK
| | | | | | | | | | | |
Collapse
|
40
|
Platt A, Shingler V, Taylor SC, Williams PA. The 4-hydroxy-2-oxovalerate aldolase and acetaldehyde dehydrogenase (acylating) encoded by the nahM and nahO genes of the naphthalene catabolic plasmid pWW60-22 provide further evidence of conservation of meta-cleavage pathway gene sequences. Microbiology (Reading) 1995; 141 ( Pt 9):2223-33. [PMID: 7496535 DOI: 10.1099/13500872-141-9-2223] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We report the complete nucleotide sequence and over-expression of the nahOM genes for the acetaldehyde dehydrogenase (acylating) and the 4-hydroxy-2-oxovalerate aldolase from the meta pathway operon of the naphthalene catabolic plasmid pWW60-22 from Pseudomonas sp. NCIMB9816. Additional partial sequence analysis of adjacent DNA shows the gene order within the operon to be nahNLOMK, identical to the order found for the isofunctional genes in the meta pathway operons in the toluene/xylene pathway of TOL plasmid pWW0 and the phenol/methylphenol pathway of pVI150. The deduced amino acid sequences of NahO and NahM were significantly homologous to the equivalent enzymes encoded by other Pseudomonas meta pathways, although both were the most divergent in each comparison. The nahOM genes were inserted downstream of the T7 promoter in the expression vector pET3a and similar constructs were also made of the isofunctional regions from pVI150 (dmpFG) and TOL plasmid pDK1 (xyIQK). High expression of all three gene pairs was detected by enzyme assays and by SDS-PAGE.
Collapse
Affiliation(s)
- A Platt
- Department of Biological Sciences, University of Wales, Bangor, Gwynedd, UK
| | | | | | | |
Collapse
|
41
|
Abstract
Nitrogen regulation has been extensively studied in fungi revealing a complex array of interacting regulatory genes. The general characterisation of the systems in Aspergillus nidulans and Neurospora crassa shall be briefly described, but much of this paper will concentrate specifically on the recent molecular characterisation of areA, the principle regulatory gene from A. nidulans which mediates nitrogen metabolite repression. Three areas shall be explored in detail, firstly the DNA binding domain, which has been characterised extensively by both molecular and genetic analysis. Secondly we shall report recent analysis which has revealed the presence of related DNA binding activities in A. nidulans. Finally we shall discuss the mechanism by which the nitrogen state of the cell is monitored by the areA product, in particular localisation of the domain within the areA product which mediates the regulatory response within the protein.
Collapse
Affiliation(s)
- M X Caddick
- Department of Genetics and Microbiology, Donnan Laboratories, University of Liverpool, UK
| | | | | |
Collapse
|
42
|
Stankovich M, Platt A, Caddick MX, Langdon T, Shaffer PM, Arst HN. C-terminal truncation of the transcriptional activator encoded by area in Aspergillus nidulans results in both loss-of-function and gain-of-function phenotypes. Mol Microbiol 1993. [DOI: 10.1111/j.1365-2958.1993.tb01195.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
43
|
Stankovich M, Platt A, Caddick MX, Langdon T, Shaffer PM, Arst HN. C-terminal truncation of the transcriptional activator encoded by areA in Aspergillus nidulans results in both loss-of-function and gain-of-function phenotypes. Mol Microbiol 1993; 7:81-7. [PMID: 8437521 DOI: 10.1111/j.1365-2958.1993.tb01099.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Mutations truncating as many as 143 C-terminal residues from the transcriptional activator encoded by the areA gene, mediating nitrogen metabolite repression in Aspergillus nidulans, do not significantly reduce the ability of the areA product to activate expression of most genes under areA control. Such mutations can even have a gain-of-function, derepressed phenotype, consistent with a critical role for this region in modulating the activity of the areA protein. However, expression of a few genes under areA control is substantially impaired by such C-terminal truncations, indicating that regions of an activator protein can play differing roles in the control of different structural genes. This underlines the advantages of being able to monitor effects of areA mutations on expression of large numbers of structural genes. Additionally, it is shown that truncation of as many as 153 C-terminal residues, virtually all amino acids C-terminal to the DNA-binding region, is compatible with retention of some areA function.
Collapse
Affiliation(s)
- M Stankovich
- Department of Chemistry, University of San Diego, California 92110-2492
| | | | | | | | | | | |
Collapse
|
44
|
Abstract
A device for the continuous collection of urine from newborn infants is described. This apparatus replaces the nursing tray of the Vickers 59 incubator.
Collapse
|
45
|
Platt A. Migrant coalition is seeking to improve health care. Zahnarztl Prax 1970; 21:16-7 passim. [PMID: 5275156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|