Innovative interprofessional teaching session on labour and childbirth for undergraduate medical and midwifery students

There is an increasing recognition of the need to improve interprofessional relationships within clinical practice (Midwifery 2020, 2010). Evidence supports the assertion that healthcare professionals who are able to communicate and work effectively together and who have a mutual respect and understanding for one another’s roles will provide a higher standard of care (McPherson et al, 2001; Miers et al, 2005; Begley, 2008). The joint Royal College of Obstetrics & Gynaecologists(RCOG) / Royal College of Midwives (RCM) report (2008 Page 8) on clinical learning environment and recruitment recommended that “Inter-professional learning strategies should be introduced and supported at an early stage in the medical and midwifery undergraduate students' experience and continued throughout training.” Providing interprofessional education within a University setting offers an opportunity for a non-threatening learning environment where students can develop confidence and build collaborative working relationships with one another (Saxell et al, 2009).Further research supports the influence of effective team working on increased client satisfaction. Additionally it identifies that the integration of interprofessional learning into a curriculum improves students’ abilities to interact professionally and provides a better understanding of role identification within the workplace than students who have only been exposed to uniprofessional education (Meterko et al, 2004; Pollard and Miers, 2008; Siassakos, et al, 2009; Wilhelmsson et al, 2011; Murray-Davis et al, 2012). An interprofessional education indicative has been developed by teaching staff from the School of Nursing and Midwifery and School of Medicine at Queen’s University Belfast. The aim of the collaboration was to enhance interprofessional learning by providing an opportunity for medical students and midwifery students to interact and communicate prior to medical students undertaking their obstetrics and gynaecology placements. This has improved medical students placement experience by facilitating them to learn about the process of birth and familiarisation of the delivery suite environment and it also has the potential to enhance interprofessional relationships. Midwifery students benefit through the provision of an opportunity to teach and facilitate learning in relation to normal labour and birth and has provided them with an opportunity to build stronger and more positive relationships with another profession. This opportunity also provides a positive, confidence building forum where midwifery students utilise teaching and learning strategies which would be transferable to their professional role as registered midwives. The midwifery students were provided with an outline agenda in relation to content for the workshop, but then were allowed creative licence with regard to delivery of the workshop. The interactive workshops are undertaken within the University’s clinical education centre, utilising low fidelity simulation. The sessions are delivered 6 times per year and precede the medical students’ obstetric/gynaecology placement. All 4th year medical and final year midwifery students have an opportunity to participate. Preliminary evaluations of the workshops have been positive from both midwifery and medical students. The teaching sessions provided both midwifery and medical students with an introduction to inter professional learning and gave them an opportunity to learn about and respect each other’s roles. The midwifery students have commented on the enjoyable aspects of team working for preparing for the workshop and also the confidence gained from teaching medical students. The medical students have evaluated the teaching by midwifery students positively and felt that it lowered their anxiety levels going into the labour setting. A number of midwifery and medical students have subsequently worked with one another within the practice setting which has been recognised as beneficial. Both Schools have recognised the benefits of interprofessional education and have subsequently made a commitment to embed it within each curriculum.

A miR-433 mediated mechanism of chemoresistance in high grade serous ovarian cancer (HGSOC).

Higher expression of the miR-433 microRNA (miRNA) is associated with poorer survival outcomes in patients with HGSOC that may be overcome by a greater understanding of the functional role of this miRNA. We previously described miR-433 as a critical cell cycle regulator and mediator of cellular senescence. Downregulation of the mitotic arrest deficiency 2 (MAD2) protein by miR-433 led to increased cellular resistance to paclitaxel in epithelial ovarian cancer cells (EOC). Furthermore immunohistochemical (IHC) analysis of MAD2 expression in patients with HGSOC showed that loss of MAD2 was significantly associated with poorer patient survival. Higher miR-433 expression is also associated with an increased resistance to the platins which is unrelated to loss of MAD2 expression. In silico analysis of the miR-433 target proteins in the TCGA database identified the association between a number of miR-433 targets and poorer patient survival. IHC analysis of the miR-433 target, histone deacetylase 6 (HDAC6), confirmed that its expression was significantly associated with a decrease in patient overall survival. The knock-down of HDAC6 by siRNA in EOC cells did not attenuate apoptotic responses to paclitaxel or platin although lower endogenous HDAC6 expression was associated with more resistant EOC cell lines. In vitro analysis revealed that EOC cells which survived chemotherapeutic kill with high doses of paclitaxel expressed higher miR-433 and concomitant decreased expression of the miR-433 targets. These cells were more chemoresistant compared to the parental cell line and repopulated as 3d organoid cultures in non-adherent stem cell selective conditions; thus indicating that the cells which survive chemotherapy were viable, capable of regrowth and had an increased potential for pluripotency. In conclusion, our data suggests that chemotherapy is not driving the transcriptional upregulation of miR-433 but rather selecting a population of cells with high miR-433 expression that may contribute to chemoresistant disease and tumour recurrence.

An experimental evaluation of prediction models for the mechanical behavior of unreinforced, lime-mortar masonry under compression

This paper contributes to the understanding of lime-mortar masonry strength and deformation (which determine durability and allowable stresses/stiffness in design codes) by measuring the mechanical properties of brick bound with lime and lime-cement mortars. Based on the regression analysis of experimental results, models to estimate lime-mortar masonry compressive strength are proposed (less accurate for hydrated lime (CL90s) masonry due to the disparity between mortar and brick strengths). Also, three relationships between masonry elastic modulus and its compressive strength are proposed for cement-lime; hydraulic lime (NHL3.5 and 5); and hydrated/feebly hydraulic lime masonries respectively.

Disagreement between the experimental results and former mathematical prediction models (proposed primarily for cement masonry) is caused by a lack of provision for the significant deformation of lime masonry and the relative changes in strength and stiffness between mortar and brick over time (at 6 months and 1 year, the NHL 3.5 and 5 mortars are often stronger than the brick). Eurocode 6 provided the best predictions for the compressive strength of lime and cement-lime masonry based on the strength of their components. All models vastly overestimated the strength of CL90s masonry at 28 days however, Eurocode 6 became an accurate predictor after 6 months, when the mortar had acquired most of its final strength and stiffness.

The experimental results agreed with former stress-strain curves. It was evidenced that mortar strongly impacts masonry deformation, and that the masonry stress/strain relationship becomes increasingly non-linear as mortar strength lowers. It was also noted that, the influence of masonry stiffness on its compressive strength becomes smaller as the mortar hydraulicity increases.

Academic and Practitioners perspectives on Organisation Development – a UK study

This paper reports on a research study to identify the nature of the profession of Organisation Development (OD) in the UK and how it has evolved over four decades. The study is designed to compare academic perspectives on OD with what is happening in the professional practice world. Three forms of data were collected for this study, content analysis of job advertisements from a four decade period, a bibliometric search and interviews with subject experts. The findings were analysed through the theory lens of institutional theory, the dissemination of ideas and fads and fashions in management. Emerging insights are that there is a difference between academic and practitioners development of the OD profession in the UK. The reasons for the difference have been explored in the discussion.

Millimeter Wave Amplitude Comparison Monopulse Using a Waveguide Rotman Lens

A 94 GHz waveguide Rotman lens is described which can be used to implement an amplitude comparison monopulse RADAR. In transmit mode, adjacent dual beam ports are excited with equal amplitude and phase to form a sum radiation pattern, and in receive mode, the outputs of the beam port pairs are combined using magic tees to provide a sum and a difference signal which can be used to calculate an angular error estimate for target acquisition and tracking. This approach provides an amplitude comparison monopulse system which can be scanned in azimuth and which has a low component count, with no requirement for phase shift circuitry in the array feed lines, making it suitable for mm-wave frequencies. A 12 input (beam ports), 12 output (array ports) lens is designed using CST Microwave Studio, and the predicted results are presented.

Regulation of TLR2, TLR4 and CD14 mRNA in gingival fibroblasts.

Gingival fibroblasts constitutively express pattern recognition molecules including the Toll-like receptors (TLRs) and produce various cytokines following interaction with bacterial ligands including LPS. Hence gingival fibroblasts are thought to play an important role in the pathogenesis of chronic inflammatory periodontal disease.
Objectives: The aim of this study was to investigate the regulation of expression of TLRs and CD-14 mRNA by gingival fibroblasts, and subsequently the responsiveness of these cells to bacterial stimulation Methods: Gingival fibroblasts were stimulated with IL-1ß (10ng/ml), IFN-g (1000IU/ml), P. gingivalis LPS (1µg/ml), E. coli LPS (1µg/ml) or P. gingivalis sonicate (10µg/ml) for 6 and 24 hr. TLR2, TLR4 and CD14 mRNA expression was subsequently determined by Q-PCR utilising Taqman chemistry. The effects of each factor on mRNA expression was analysed by ANOVA. Cells were pre-incubated with IFN-g (1000IU/ml) for 48hr followed by stimulation with E. coli LPS over the concentration range 0 - 10.0 µg/ml for a further 48 hr. IL-8 production by fibroblasts was subsequently determined by ELISA. Results: After 24 hr IFN-g induced a statistically significant increase in TLR2, TLR4 and CD14 mRNA expression. In contrast, IL-1ß, P. gingivalis LPS, E. coli LPS and P. gingivalis sonicate had no significant effect on mRNA expression at either timepoint. Following pre-stimulation with IFN-g, E. coli LPS increased IL-8 production by gingival fibroblasts in a concentration-dependent manner. Conclusion: IFN-g stimulates mRNA expression levels of TLR2, TLR4 and CD14 in gingival fibroblasts, which may subsequently lead to an increased responsiveness of fibroblasts to bacterial stimulation.

On the Source of Propagating Slow Magnetoacoustic Waves in Sunspots

Recent high-resolution observations of sunspot oscillations using simultaneously operated ground- and space-based telescopes reveal the intrinsic connection between different layers of the solar atmosphere. However, it is not clear whether these oscillations are externally driven or generated in situ. We address this question by using observations of propagating slow magnetoacoustic waves along a coronal fan loop system. In addition to the generally observed decreases in oscillation amplitudes with distance, the observed wave amplitudes are also found to be modulated with time, with similar variations observed throughout the propagation path of the wave train. Employing multi-wavelength and multi-instrument data, we study the amplitude variations with time as the waves propagate through different layers of the solar atmosphere. By comparing the amplitude modulation period in different layers, we find that slow magnetoacoustic waves observed in sunspots are externally driven by photospheric p-modes, which propagate upward into the corona before becoming dissipated.