A feasibility study on the development and integration of a teaching aid for pharmacology

Traditional methods of teaching and learning in higher education are ever-evolving. This report assesses the feasibility of developing a teaching aid for pharmacology modules. Focus groups were established to gauge student and staff opinions on the use of teaching aids and an extensive literature review was conducted. The study identifies and critically evaluates a range of possibilities that could be developed and discusses practical issues such as accessibility, inclusion and assessment, associated with these potential aids. This initial study concludes that a suitable aid could take the form of a student-led development of a wiki-type website resource that included access to case-studies giving students ‘real-life’ experience of the concepts being studied. This type of project requires considerable time and financial support; nevertheless, this idea could be extended for many drugs and could be used in any health science course.

Studies in the use of magnetic microspheres for immunoaffinity extraction of paralytic shellfish poisoning toxins from shellfish

Paralytic shellfish poisoning (PSP) is a potentially fatal human health condition caused by the consumption of shellfish containing high levels of PSP toxins. Toxin extraction from shellfish and from algal cultures for use as standards and analysis by alternative analytical monitoring methods to the mouse bioassay is extensive and laborious. This study investigated whether a selected MAb antibody could be coupled to a novel form of magnetic microsphere (hollow glass magnetic microspheres, brand name Ferrospheres-N) and whether these coated microspheres could be utilized in the extraction of low concentrations of the PSP toxin, STX, from potential extraction buffers and spiked mussel extracts. The feasibility of utilizing a mass of 25 mg of Ferrospheres-N, as a simple extraction procedure for STX from spiked sodium acetate buffer, spiked PBS buffer and spiked mussel extracts was determined. The effects of a range of toxin concentrations (20-300 ng/mL), incubation times and temperature on the capability of the immuno-capture of the STX from the spiked mussel extracts were investigated. Finally, the coated microspheres were tested to determine their efficiency at extracting PSP toxins from naturally contaminated mussel samples. Toxin recovery after each experiment was determined by HPLC analysis. This study on using a highly novel immunoaffinity based extraction procedure, using STX as a model, has indicated that it could be a convenient alternative to conventional extraction procedures used in toxin purification prior to sample analysis.

A feasibility study testing four hypotheses with phase II outcomes in advanced colorectal cancer (MRC FOCUS3): a model for randomised controlled trials in the era of personalised medicine?

Background: Molecular characteristics of cancer vary between individuals. In future, most trials will require assessment of biomarkers to allocate patients into enriched populations in which targeted therapies are more likely to be effective. The MRC FOCUS3 trial is a feasibility study to assess key elements in the planning of such studies.

Patients and methods: Patients with advanced colorectal cancer were registered from 24 centres between February 2010 and April 2011. With their consent, patients' tumour samples were analysed for KRAS/BRAF oncogene mutation status and topoisomerase 1 (topo-1) immunohistochemistry. Patients were then classified into one of four molecular strata; within each strata patients were randomised to one of two hypothesis-driven experimental therapies or a common control arm (FOLFIRI chemotherapy). A 4-stage suite of patient information sheets (PISs) was developed to avoid patient overload.

Results: A total of 332 patients were registered, 244 randomised. Among randomised patients, biomarker results were provided within 10 working days (w.d.) in 71%, 15 w.d. in 91% and 20 w.d. in 99%. DNA mutation analysis was 100% concordant between two laboratories. Over 90% of participants reported excellent understanding of all aspects of the trial. In this randomised phase II setting, omission of irinotecan in the low topo-1 group was associated with increased response rate and addition of cetuximab in the KRAS, BRAF wild-type cohort was associated with longer progression-free survival.

Conclusions: Patient samples can be collected and analysed within workable time frames and with reproducible mutation results. Complex multi-arm designs are acceptable to patients with good PIS. Randomisation within each cohort provides outcome data that can inform clinical practice.

Improving Feasibility of Point to Point Operations Through Civil Aerial Refuelling

Re-imagining of the aerial transportation system has become increasingly important as the need for significant environmental and economic efficiency gains has become ever more prevalent. A number of studies have highlighted the benefits of the adoption of air to air refuelling within civil aviation. However, it also opens up the potential for increased flexibility in operations through smaller aircraft, shifting emphasis away from the traditional hub and spoke method of operation towards the more flexible Point to Point operations. It is proposed here that one technology can act as an enabler for the other, realising benefits that neither can realise as a standalone. The impact of an air-toair refuelling enabled point to point system is discussed, and the affect on economic and environmental cost metrics relative to traditional operations evaluated. An idealised airport configuration study shows the difference in fuel burn for point to point networks to vary from -23% to 28% from that of Hub and Spoke depending on the configuration. The sensitive natures of the concepts are further explored in a second study based on real airport configurations. The complex effect of the choice of a Point to Point or Hub and Spoke system on fuel burn, operating cost and revenue potential is highlighted. Fuel burn savings of 15% can be experienced with AAR over traditional refuelling operations, with point to point networks increasing the available seat miles (by approximately 20%) without a proportional increase in operating cost or fuel.

Development and Application of Medication Appropriateness Indicators for Persons with Advanced Dementia: A Feasibility Study

Background: No studies have been conducted in the UK context to date that categorise medications in terms of appropriateness for patients with advanced dementia, or that examine medication use in these vulnerable patients.

Objectives: The objectives of this study were to categorise the appropriateness of a comprehensive list of medications and medication classes for use in patients with advanced dementia; examine the feasibility of conducting a longitudinal prospective cohort study to collect clinical and medication use data; and determine the appropriateness of prescribing for nursing home residents with advanced dementia in Northern Ireland (NI), using the categories developed.

Methods: A three-round Delphi consensus panel survey of expert clinicians was used to categorise the appropriateness of medications for patients with advanced dementia [defined as having Functional Assessment Staging (FAST) scores ranging from 6E to 7F]. This was followed by a longitudinal prospective cohort feasibility study that was conducted in three nursing homes in NI. Clinical and medication use for participating residents with advanced dementia (FAST scores ranging from 6E to 7F) were collected and a short test of dementia severity administered. These data were collected at baseline and every 3 months for up to 9 months or until death. For those residents who died during the study period, data were also collected within 14 days of death. The appropriateness ratings from the consensus panel survey were retrospectively applied to residents’ medication data at each data collection timepoint to determine the appropriateness of medications prescribed for these residents.

Results: Consensus was achieved for 87 (90 %) of the 97 medications and medication classes included in the survey. Fifteen residents were recruited to participate in the longitudinal prospective cohort feasibility study, four of whom died during the data collection period. Mean numbers of medications prescribed per resident were 16.2 at baseline, 19.6 at 3 months, 17.4 at 6 months and 16.1 at 9 months. Fourteen residents at baseline were taking at least one medication considered by the consensus panel to be never appropriate, and approximately 25 % of medications prescribed were considered to be never appropriate. Post-death data collection indicated a decrease in the proportion of never appropriate medications and an increase in the proportion of always appropriate medications for those residents who died.

Conclusions: This study is the first to develop and apply medication appropriateness indicators for patients with advanced dementia in the UK setting. The Delphi consensus panel survey of expert clinicians was a suitable method of developing such indicators. It is feasible to collect information on quality of life, functional performance, physical comfort, neuropsychiatric symptoms and cognitive function for this subpopulation of nursing home residents with advanced dementia.

Atmospheric cold plasma process for vegetable leaf decontamination: A feasibility study on radicchio (red chicory, Cichorium intybus L.)

Cold plasma is an emerging non-thermal processing technology that could be used for large scale leaf decontamination as an alternative to chlorine washing. In this study the effect of an atmospheric cold plasma apparatus (air DBD, 15 kV) on the safety, antioxidant activity and quality of radicchio (red chicory, Cichorium intybus L.) was investigated after 15 and 30 min of treatment (in afterglow at 70 mm from the discharge, at 22 °C and 60% of RH) and during storage. Escherichia coli O157:H7 inoculated on radicchio leaves was significantly reduced after 15 min cold plasma treatment (-1.35 log MPN/cm²). However, a 30 min plasma treatment was necessary to achieve a significant reduction of Listeria monocytogenes counts (-2.2 log CFU/cm²). Immediately after cold plasma treatment, no significant effects emerged in terms of antioxidant activity assessed by the ABTS and ORAC assay and external appearance of the radicchio leaves. Significant changes between treated and untreated radicchio leaves are quality defects based on the cold plasma treatment. Atmospheric cold plasma appears to be a promising processing technology for the decontamination of leafy vegetables although some criticalities, that emerged during storage, need to be considered in future studies.

A Design & Feasibility Study of the Spaced Learning Programme

Objectives There is evidence from neuroscience, cognitive psychology and educational research that the delivery of a stimulus in a spaced format (over time) rather than a massed format (all at once) leads to more effective learning. This project aimed to pilot spaced learning materials using various spacing lengths for GCSE science by exploring the feasibility of introducing spaced leaning into regular classrooms and by evaluating teacher fidelity to the materials. The spaced learning methods will then be compared with traditional science revision techniques and a programme manual will be produced. Design A feasibility study. Methods A pilot study (4 schools) was carried out to examine the feasibility and teacher fidelity to the materials, using pupil workshops and teacher interviews. A subsequent random assignment experimental study (12 schools) will involve pre and post testing of students on a science attainment measure and a post-test implementation questionnaire. Results The literature review found that longer spacing intervals between repetitions of material (>24 hours) may be optimal for long term memory formation than shorter intervals. A logic model was developed to inform the design of various programme variants for the pilot and experimental study. This paper will report qualitative data from the initial pilot study. Conclusions The paper uses this research project as an example to explain the importance of conducting pilot work and small scale experimental studies to explore the feasibility and inform the design of educational interventions, rather than prematurely moving to RCT type studies.

Investigating Feasibility of Drive-by Bridge Monitoring by Laboratory Experiments

A potentially powerful drive-by bridge inspection approach was proposed to inspect bridge conditions utilizing the vibrations of a test vehicle while it passes over the target bridge. This approach suffers from the effect of roadway surface roughness and two solutions were proposed in previous studies: one is to subtract the responses of two vehicles (time-domain method) before spectral analysis and the other one is to subtract the spectrum of one vehicle from that of the other (frequency-domain method). Although the two methods were verified theoretically and numerically, their practical effectiveness is still an open question.Furthermore, whether the outcome spectra processed by those methods could be used to detect potential bridge damage is of our interests. In this study, a laboratory experiment was carried out with a test tractor-trailer system and a scaled bridge. It was observed that, first, for practical applications, it would be preferable to apply the frequency-domain method, avoiding the need to meet a strict requirement in synchronizing the responses of the two trailers in time domain; second, the statistical pattern of the processed spectra in a specific frequency band could be an effective anomaly indicator incorporated in drive-by inspection methods.